Individual provider Active NPI

Ijeoma C Eleazu, MD

  • Cardiovascular Disease Physician
  • Boston, MA
National Provider Identifier
1336639277
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
104770 Issued in GA
Practice address
55 Fruit St
Boston, MA 02114-2621
Phone
(617) 724-4133
NPI assigned
May 16, 2018
Last updated
Jun 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 104770 GA Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2621

Mailing address

125 Nashua St Ste 260
Boston, MA 02114-1109

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20251105002138 GA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 3678825080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Rutgers New Jersey Medical School, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emory Medical Care Foundation IncGroup PAC ID 4981501814, 1,003 clinicians

Practice addresses (Care Compare)

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031
Phone (404) 616-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
104770GAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc CurrentSince Sep 1, 2025 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Sep 1, 2025 Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

Interoperability endpoints

  • Direct secure messaging: ieleazu298193@direct.phhs.org

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1526428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782432000000",
    "number": "1336639277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 NASHUA ST STE 260",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021141109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-724-4133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELEAZU",
        "first_name": "IJEOMA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-16",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "104770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.