Active NPI
Edjah Nduom, MD
- Neurological Surgery Physician
- Bethesda, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- 85703
- Practice address
- 10 Center Dr 10/3D20, MSC 1414
Bethesda, MD 20892-1013 - Phone
- (301) 496-2921
- NPI assigned
- Feb 17, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | 002213 | GA | |
| Neurological Surgery Physician | 207T00000X | 85703 | GA | Primary |
| Neurological Surgery Physician | 207T00000X | P9918 | TX |
Addresses
Primary practice location
10 Center Dr 10/3D20, MSC 1414
Bethesda, MD 20892-1013
Mailing address
1365B Clifton Rd NE
Suite 6400
Atlanta, GA 30322-1013
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8EJ129 (MDACC) | Other | TX | BCBS |
| 335993701 (MDACC) | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA, GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Neurosurgery
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525
Hospital & facility affiliations
- Emory University Hospital
- Emory University Hospital Midtown
- Emory Decatur Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002213 | GA | MD | Neurological Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emory Medical Care Foundation Inc | Current | Accepting new patients | |
| The Emory Clinic Inc | Current | Accepting new patients | |
| Emory Medical Care Foundation Inc | Current | Accepting new patients | |
| Emory Health Care | Past | Accepting new patients | |
| Emory University | Past | Accepting new patients |
Locations
80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370
1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525
1365 Clifton Rd NE
Ste 6400
Atlanta, GA 30322
1365 Clifton Rd NE
Ste B2200
Atlanta, GA 30322
Phone (404) 778-5770
101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889
Interoperability endpoints
- enduom21815@direct.emory.org
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Atlanta, GA
- NPI 1396798229
-
- Internal Medicine Physician
- Atlanta, GA
- NPI 1063452381
-
- Diagnostic Radiology Physician
- Atlanta, GA
- NPI 1225294739
-
- Neurology Physician
- Atlanta, GA
- NPI 1376642751
-
- General Acute Care Hospital
- Atlanta, GA
- NPI 1588640692
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Atlanta, GA
- NPI 1144203563
-
- General Acute Care Hospital
- Decatur, GA
- NPI 1093716979
-
- General Acute Care Hospital
- Atlanta, GA
- NPI 1588640692
-
- General Acute Care Hospital
- Atlanta, GA
- NPI 1770560294
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607040000000",
"number": "1285802801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1365B CLIFTON RD NE",
"address_2": "SUITE 6400",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303221013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 CENTER DR 10/3D20, MSC 1414",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208921013",
"telephone_number": "301-496-2921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NDUOM",
"first_name": "EDJAH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-02-17",
"last_updated": "2020-12-04",
"certification_date": "2020-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "GA",
"license": "002213",
"primary": false
},
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "GA",
"license": "85703",
"primary": true
},
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "TX",
"license": "P9918",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8EJ129 (MDACC)",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "335993701 (MDACC)",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bethesda, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.