Individual provider Active NPI

Ikechukwu Ifeanyi Onyedika, M.D.

  • Pediatric Orthopaedic Surgery Physician
  • El Paso, TX
National Provider Identifier
1306008180
Registry record updated Jan 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X
License
R1096 Issued in TX
Practice address
4646 N Mesa St
El Paso, TX 79912-6104
Phone
(915) 313-6300
Fax
(915) 521-2028
NPI assigned
Jul 2, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Orthopaedic Surgery Physician 207XP3100X R1096 TX Primary

Addresses

Primary practice location

4646 N Mesa St
El Paso, TX 79912-6104

Mailing address

4646 N Mesa St
El Paso, TX 79912-6104
Phone (915) 313-6300

Other identifiers 1

IdentifierTypeStateIssuer
R1096OtherTXTEXAS MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170215002238 TX Practitioner - Orthopedic SurgeryPractitioner - Pediatric Medicine 3971818899 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Pediatric Medicine
Education
Albany Medical College of Union University, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BHS Physicians Network, IncGroup PAC ID 7315019593, 702 clinicians

Practice addresses (Care Compare)

4646 N Mesa St
El Paso, TX 79912-6104
Phone (915) 313-6300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R1096TXMDPediatric Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
BHS Physicians Network, Inc CurrentSince Jun 1, 2017 Accepting new patients
BHS Physicians Network, Inc CurrentSince Jun 1, 2017 Accepting new patients
Tenet Hospitals Limited Past Accepting new patients
BHS Specialty Network Inc Past Accepting new patients

Locations

4646 N Mesa St
El Paso, TX 79912
Phone (915) 533-1628

1732 Weston Brent Ln
Ste F
El Paso, TX 79935

631 N Resler Dr
Ste 101
El Paso, TX 79912
Phone (915) 842-0676

3903 Wiseman Blvd
Ste 100
San Antonio, TX 78251
Phone (210) 681-0126

3903 Wiseman Blvd
San Antonio, TX 78251
Phone (210) 681-0126

Interoperability endpoints

  • Direct secure messaging: ikechukwu.onyedika.1@1438.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1306008180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4646 N MESA ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799126104",
            "telephone_number": "915-313-6300",
            "fax_number": "915-521-2028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 N MESA ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799126104",
            "telephone_number": "915-313-6300",
            "fax_number": "915-521-2028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONYEDIKA",
        "first_name": "IKECHUKWU",
        "middle_name": "IFEANYI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-02",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "TX",
            "license": "R1096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL LICENSE",
            "identifier": "R1096",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.