Ngozi Bridget Agorua, NP-C

Individual provider Active NPI Family Nurse Practitioner · Broken Arrow, OK

NPI 1316515554 · NPPES record last updated Sep 7, 2023

Key facts

NPI
1316515554
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
1073489 (TX)
Practice address
904 S Aster Ave
Broken Arrow, OK 74012-8833
Phone
(405) 410-2586
NPI assigned
Jun 15, 2021
Sex
Female
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kelsey-Seybold Medical Group, PLLC (941 clinicians)

Practice addresses (Care Compare)

2510 W Grand Pkwy N
Katy, TX 77449-2853
Phone (713) 442-4222

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in OK, TX
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20220105002213 OK Practitioner - Nurse Practitioner 0446641229 Reassigns benefits to 1 organization
I20230920001271 TX Practitioner - Nurse Practitioner 0446641229 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1073489TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kelsey-Seybold Medical Group, PLLC Current
since Sep 25, 2023
Accepting new patients
Omni Medical Group Inc Current
since Dec 28, 2021
Accepting new patients

Locations

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

1725 E 19th St
Ste 500
Tulsa, OK 74104
Phone (918) 403-7089

2727 W Holcombe Blvd
Houston, TX 77025
Phone (713) 790-9412

2510 W Grand Pkwy N
Katy, TX 77449
Phone (713) 442-4222

11511 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 442-4997

Interoperability endpoints

  • Direct secure messaging: nagorua66807@direct.kelsey-seybold.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1073489 TX Yes

Addresses

Primary practice location

904 S Aster Ave
Broken Arrow, OK 74012-8833

Mailing address

11511 Shadow Creek Pkwy
Pearland, TX 77584-7298
Phone (713) 442-0000

Other practice location 1

2510 W Grand Pkwy N
Katy, TX 77449-2853
Phone (713) 442-4222

Other identifiers

IdentifierTypeStateIssuer
1073489OtherTXTEXAS NURSING BOARD
R0114832OtherOKRN
U082527746OtherOKDRIVERS LICENSE

Other providers in Broken Arrow, OK

All providers in Broken Arrow, OK · Family Nurse Practitioner in Oklahoma

Sources for this page

Verify at the official NPI Registry.