Individual provider Active NPI

Anthony Nnamdi Ezeagbor, M.D.

  • Internal Medicine Physician
  • Yonkers, NY
National Provider Identifier
1316084577
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
239273 Issued in NY
Practice address
1 Alexander St Apt 713C
Yonkers, NY 10701-7565
Phone
(917) 971-2565
Fax
(917) 971-2565
NPI assigned
Jan 30, 2007
Last updated
Jul 11, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 239273 NY
Internal Medicine Physician 207R00000X 239273 NY Primary

Addresses

Primary practice location

1 Alexander St Apt 713C
Yonkers, NY 10701-7565

Mailing address

1 Alexander St Apt 713C
Yonkers, NY 10701-7565
Phone (917) 971-2565

Other names 1

  • Anthony Ezeagbor Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20090610000642 NY Practitioner - Internal Medicine 0648320705 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1613 Westchester Ave
Bronx, NY 10472-2914
Phone (718) 571-9407

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as group
Quality
82.1
Promoting interoperability
100
Improvement activities
40
Cost
72.34

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
239273NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Medical Associates PC CurrentSince Jul 6, 2019 Accepting new patients
Park Hill Emergency Physician Services Emergency Medicine CurrentSince Jun 1, 2015 Accepting new patients
United Medical Associates, P.C. CurrentSince Jul 6, 2019 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Sep 22, 2022 Accepting new patients
City Medical of Upper East Side, PLLC Current Accepting new patients
Medical Services of Suffolk County PC Emergency Medicine CurrentSince Mar 1, 2018 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Sep 22, 2022 Accepting new patients
Williamston HBP Services LLC Emergency Medicine Past Accepting new patients
Neighborhood Medical Care PC Internal Medicine Past Accepting new patients
Peninsula Medical Services PC Emergency Medicine Past Accepting new patients
Kinston Physicians Group, PLLC Emergency Medicine PastSince Apr 19, 2020 Accepting new patients
Delaware Valley Hospital, Inc Past Accepting new patients
Dr. Oluyemi O Badero, Physician, P.C. Past Accepting new patients
Atlantic Professional Services of Rhode Island Incorporated Past Accepting new patients

Locations

66 W Gilbert St
Tinton Falls, NJ 07701
Phone (732) 212-0051

2248 31st St
Astoria, NY 11105
Phone (718) 267-1333

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

10-42 Mitchell Ave
Binghamton, NY 13903
Phone (607) 762-2468

1613 Westchester Ave
Bronx, NY 10472
Phone (718) 571-9407

33-57 Harrison St
Johnson City, NY 13790
Phone (607) 763-6412

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

127 S Broadway
Yonkers, NY 10701
Phone (914) 378-7342

Interoperability endpoints

  • Direct secure messaging: anthony.ezeagbor.1@2983.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1316084577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ALEXANDER ST APT 713C",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107017565",
            "telephone_number": "917-971-2565",
            "fax_number": "917-971-2565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ALEXANDER ST APT 713C",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107017565",
            "telephone_number": "917-971-2565",
            "fax_number": "917-971-2565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZEAGBOR",
        "first_name": "ANTHONY",
        "middle_name": "NNAMDI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "239273",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "239273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANTHONY",
            "last_name": "EZEAGBOR",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Yonkers, NY

Sources for this page

Verify at the official NPI Registry.