Individual provider Active NPI

Stella Chidi Ohanenye, O.D.

  • Optometrist
  • North East, MD
National Provider Identifier
1326148412
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA1808 Issued in MD
Practice address
75 N East Rd
North East, MD 21901-3613
Phone
(410) 287-3723
Fax
(410) 287-3826
NPI assigned
Sep 25, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA1808 MD Primary

Addresses

Primary practice location

75 N East Rd
North East, MD 21901-3613

Mailing address

75 N East Rd
North East, MD 21901-3613
Phone (410) 287-3723

Other names 1

  • Dr. Stella Chidi Mbakwe Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160223001791 DE Practitioner - Optometry 9032414446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

600 N Broad St
Suite 12
Middletown, DE 19709-1032
Phone (302) 563-8820

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TA1808MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Amy M Farrall OD LLC Optometrist PastSince Jan 9, 2016 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326148412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 N EAST RD",
            "city": "NORTH EAST",
            "state": "MD",
            "postal_code": "219013613",
            "telephone_number": "410-287-3723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 N EAST RD",
            "city": "NORTH EAST",
            "state": "MD",
            "postal_code": "219013613",
            "telephone_number": "410-287-3723",
            "fax_number": "410-287-3826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OHANENYE",
        "first_name": "STELLA",
        "middle_name": "CHIDI",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STELLA",
            "last_name": "MBAKWE",
            "middle_name": "CHIDI",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in North East, MD

Sources for this page

Verify at the official NPI Registry.