Individual provider Active NPI

Ada K Obidike, M.D.

  • Internal Medicine Physician
  • Norwalk, CT
National Provider Identifier
1366722399
Registry record updated Jun 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
53075 Issued in CT
Practice address
34 Maple St
Norwalk, CT 06850-3815
Phone
(203) 852-2000
NPI assigned
Aug 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 255876 NY
Internal Medicine Physician 207R00000X 53075 CT Primary

Addresses

Primary practice location

34 Maple St
Norwalk, CT 06850-3815

Mailing address

34 Maple St
Norwalk, CT 06850-3815
Phone (203) 852-2000

Other identifiers 1

IdentifierTypeStateIssuer
03484631MedicaidNY

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140626002057 CT Practitioner - Internal Medicine 6800041625 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Albert Einstein College of Medicine of Yeshiva University, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nuvance Health Medical Practice CT IncGroup PAC ID 4789597691, 742 clinicians

Practice addresses (Care Compare)

24 Hospital Ave
Danbury, CT 06810-6099
Phone (203) 739-7118

34 Maple St
Norwalk, CT 06850-3815
Phone (203) 762-5588

Hospital & facility affiliations

  • Norwalk Hospital Hospital, Norwalk, CT, CCN 070034

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
255876NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvance Health Medical Practice CT, Inc. Internal Medicine CurrentSince Feb 9, 2015 Accepting new patients

Locations

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

38 East Ave
New Canaan, CT 06840
Phone (203) 594-9520

34 Maple St
Norwalk, CT 06850
Phone (203) 852-2000

111 E 210th St
Bronx, NY 10467

Interoperability endpoints

  • Direct secure messaging: aobidike846746@nychhc.direct-ci.com

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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": "1313971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402876800000",
    "number": "1366722399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 MAPLE ST",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068503815",
            "telephone_number": "203-852-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 MAPLE ST",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068503815",
            "telephone_number": "203-852-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBIDIKE",
        "first_name": "ADA",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-22",
        "last_updated": "2014-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "255876",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "53075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03484631",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

Verify at the official NPI Registry.