Individual provider Active NPI

Chizor J Iwuchukwu, M.D.

  • Interventional Cardiology Physician
  • Cape Girardeau, MO
National Provider Identifier
1386736379
Registry record updated Mar 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
2013025678 Issued in MO
Practice address
371 S Broadview St
Cape Girardeau, MO 63703-5761
Phone
(573) 331-6710
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 230469 NY
Student in an Organized Health Care Education/Training Program 390200000X 43975 TN
Interventional Cardiology Physician 207RI0011X 2013025678 MO Primary

Addresses

Primary practice location

371 S Broadview St
Cape Girardeau, MO 63703-5761

Mailing address

371 S Broadview St
Cape Girardeau, MO 63703-5761
Phone (573) 331-6710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20131109000614 MO Practitioner - Interventional CardiologyPractitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 3274768759 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Missouri Hospital Physicians LLCGroup PAC ID 9133024334, 206 clinicians

Practice addresses (Care Compare)

1701 Lacey St
Cape Girardeau, MO 63701-5230
Phone (573) 334-4822

Hospital & facility affiliations

  • Mercy Hospital Southeast Hospital, Cape Girardeau, MO, CCN 260110
  • Mercy Hospital Perry Hospital, Perryville, MO, CCN 261311
  • Mercy Hospital Stoddard Hospital, Dexter, MO, CCN 260160
  • Missouri Delta Medical Center Hospital, Sikeston, MO, CCN 260113
  • Saint Francis Medical Center Hospital, Cape Girardeau, MO, CCN 260183

Merit-based Incentive Payment System (MIPS)

Final score
23.38 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
77.93

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting18
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
230469NYMDInternal Medicine Physician
43975TNMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Hospital CurrentSince Aug 28, 2013 Accepting new patients
Southeast Missouri Hospital Physicians, LLC CurrentSince Aug 7, 2013 Accepting new patients
Southeast Hospital CurrentSince Aug 28, 2013 Accepting new patients

Locations

371 S Broadview St
Cape Girardeau, MO 63703
Phone (573) 331-6710

1701 Lacey St
Cpe Girardeau, MO 63701
Phone (573) 334-4822

1200 N One Mile Rd
Ste 1
Dexter, MO 63841

434 N West St
Perryville, MO 63775
Phone (573) 547-2530

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.

Hospital & facility affiliations 6

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394668800000",
    "number": "1386736379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "371 S BROADVIEW ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035761",
            "telephone_number": "573-331-6710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371 S BROADVIEW ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035761",
            "telephone_number": "573-331-6710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IWUCHUKWU",
        "first_name": "CHIZOR",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2014-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "230469",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TN",
            "license": "43975",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MO",
            "license": "2013025678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.