Active NPI
Judith Chinenye Ukabam, M.D.
- Geriatric Medicine (Internal Medicine) Physician
- Willimantic, CT
National Provider Identifier
1306370010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- License
- 67254
- Practice address
- 5 Founders St Ste 100
Willimantic, CT 06226-2049 - Phone
- (860) 423-9764
- Fax
- (860) 724-2580
- NPI assigned
- Apr 19, 2017
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 67254 | CT | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | 67254 | CT | Primary |
Addresses
Primary practice location
5 Founders St Ste 100
Willimantic, CT 06226-2049
Mailing address
251 E Huron St
Chicago, IL 60611-2908
Other practice location 1
2900 N Lake Shore Dr
Chicago, IL 60657-5640
Phone (773) 665-6730
Other practice location 2
251 E Huron St
Chicago, IL 60611-2908
Phone (312) 503-4748
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210331001574 | CT | Practitioner - Internal Medicine | 2163846726 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Hartford Healthcare Medical Group Specialists PLLC
Practice addresses (Care Compare)
1244 Storrs Rd
Road
Storrs, CT 06268-2200
Phone (860) 724-2579
30 Loeffler Rd
Bloomfield, CT 06002-2256
Phone (860) 380-5150
Hospital & facility affiliations
- Hartford Healthcare at Home
- McLean Home Care and Hospice
- Hartford Hospital
- William W Backus Hospital
- Caleb Hitchcock Health Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.48 of 100
- Quality
- 83.4
- Promoting interoperability
- 100
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.42 of 100
- Quality
- 83.36
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.9
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 67254 | CT | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hartford Healthcare Medical Group, Inc | Internal Medicine | Current | Accepting new patients |
| Hartford Healthcare Medical Group Specialists LLC | Current | Accepting new patients | |
| Hartford Healthcare Medical Group Specialists, PLLC | Current | Accepting new patients |
Locations
55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144
1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579
1290 Silas Deane Hwy
Fl 1
Wethersfield, CT 06109
Phone (860) 972-6970
5 Founders St
Willimantic, CT 06226
Phone (860) 423-9764
5 Founders St
Ste 100
Willimantic, CT 06226
Phone (860) 423-9764
Interoperability endpoints
- jukabam357935@xdr.hhchealthdirect.org
Organizations & group practices 3
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.
-
- Surgery Physician
- Hartford, CT
- NPI 1023584216
CT
-
- Surgery Physician
- Wethersfield, CT
- NPI 1043561301
CT, Internal Medicine
-
- Customized Equipment (DME)
- Groton, CT
- NPI 1295367068
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Wethersfield, CT
- NPI 1073529566
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629763200000",
"number": "1306370010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "251 E HURON ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 FOUNDERS ST STE 100",
"city": "WILLIMANTIC",
"state": "CT",
"postal_code": "062262049",
"telephone_number": "860-423-9764",
"fax_number": "860-724-2580"
}
],
"practiceLocations": [
{
"address_1": "2900 N Lake Shore Dr",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606575640",
"country_code": "US",
"telephone_number": "773-665-6730",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "251 E Huron St",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606112908",
"country_code": "US",
"telephone_number": "312-503-4748",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "UKABAM",
"first_name": "JUDITH",
"middle_name": "CHINENYE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-19",
"last_updated": "2021-08-24",
"certification_date": "2021-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CT",
"license": "67254",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "CT",
"license": "67254",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Willimantic, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; 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.