NPIMap

Individual provider Active NPI

Eboselumhen Iseghohi

  • Family Medicine Physician
  • Monona, WI
National Provider Identifier
1437642931
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OT018537 Issued in PA
Practice address
6408 Copps Ave
Monona, WI 53716-3702
Phone
(608) 417-3000
NPI assigned
Jun 8, 2018
Last updated
Nov 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 81552-21 WI
Family Medicine Physician 207Q00000X OT018537 PA Primary

Addresses

Primary practice location

6408 Copps Ave
Monona, WI 53716-3702

Mailing address

6408 Copps Ave
Monona, WI 53716-3702

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250203001196 WI Practitioner - Family Practice 4880947654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Liberty Univ College of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meriter Hospital IncGroup PAC ID 3971412735, 122 clinicians

Practice addresses (Care Compare)

6408 Copps Ave
Monona, WI 53716-3702
Phone (608) 417-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.15 of 100Reported as apm
Quality
82.31
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
81552-21WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Meriter Hospital, Inc. CurrentSince Mar 1, 2025 Accepting new patients
Meriter Hospital, Inc. Current Accepting new patients
Meriter Hospital, Inc. CurrentSince Mar 1, 2025 Accepting new patients
Meriter Hospital, Inc. Past Accepting new patients

Locations

202 S Park St
Madison, WI 53715
Phone (608) 267-6000

3102 Meriter Way
Madison, WI 53719
Phone (608) 417-8800

6408 Copps Ave
Monona, WI 53716
Phone (608) 417-3000

Interoperability endpoints

  • Direct secure messaging: eiseghohi1173223@direct.unitypoint.org
  • Direct secure messaging: eiseghohi36918@ehrdirect.uhhospitals.org

Organizations & group practices 5

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 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": "1528416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1437642931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6408 COPPS AVE",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537163702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6408 COPPS AVE",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537163702",
            "telephone_number": "608-417-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISEGHOHI",
        "first_name": "EBOSELUMHEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-08",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "81552-21",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OT018537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monona, WI

Sources for this page

Verify at the official NPI Registry.