Individual provider Active NPI

Udeme D Ekong, M.D.

  • Pediatric Transplant Hepatology Physician
  • New Haven, CT
National Provider Identifier
1376502492
Registry record updated Jan 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Transplant Hepatology PhysicianTaxonomy code 2080T0004X
License
051529 Issued in CT
Practice address
20 York St
Yale New Haven Hospital
New Haven, CT 06510-3220
Phone
(203) 785-4649
Fax
(203) 785-3365
NPI assigned
Mar 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X 036110223 IL
Pediatric Transplant Hepatology Physician 2080T0004X 051529 CT Primary

Addresses

Primary practice location

20 York St
Yale New Haven Hospital
New Haven, CT 06510-3220

Mailing address

PO Box 208064
Dept of Pediatric Gastroenterology RM 4093
New Haven, CT 06520-8064
Phone (203) 785-4649

Other identifiers 1

IdentifierTypeStateIssuer
036110223MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20190924000909 DC Practitioner - GastroenterologyPractitioner - Pediatric Medicine 3678539228 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
051529CTMDPediatric Transplant Hepatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital CurrentSince Jun 6, 2025 Accepting new patients
Medstar Medical Group II LLC CurrentSince May 1, 2025 Accepting new patients
Medstar Medical Group II LLC CurrentSince May 1, 2025 Accepting new patients
Children's Hospital CurrentSince Jun 6, 2025 Accepting new patients
Medstar Medical Group II LLC CurrentSince Sep 1, 2019 Accepting new patients
Children's Hospital Current Accepting new patients
Medstar Medical Group II LLC CurrentSince Sep 1, 2019 Accepting new patients
MGMC, LLC Current Accepting new patients
Medstar Medical Group II LLC Past Accepting new patients
Medstar - Georgetown Medical Center, Inc. Past Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

3800 Reservoir Rd NW
Washington, DC 20007
Phone (202) 687-2203

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

Organizations & group practices 10

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": "1142640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357516800000",
    "number": "1376502492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 208064",
            "address_2": "DEPT OF PEDIATRIC GASTROENTEROLOGY RM 4093",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065208064",
            "telephone_number": "203-785-4649",
            "fax_number": "203-785-3365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "address_2": "YALE NEW HAVEN HOSPITAL",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-785-4649",
            "fax_number": "203-785-3365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKONG",
        "first_name": "UDEME",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-18",
        "last_updated": "2013-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "IL",
            "license": "036110223",
            "primary": false
        },
        {
            "code": "2080T0004X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Transplant Hepatology",
            "state": "CT",
            "license": "051529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036110223",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.