Individual provider Active NPI

Ezinne Ugochi Nwotite, MD

  • Hospitalist Physician
  • Atlantic City, NJ
National Provider Identifier
1457662603
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
25MA08775000 Issued in NJ
Practice address
1925 Pacific Ave
Atlantic City, NJ 08401-6713
Phone
(609) 441-8146
Fax
(609) 441-8002
NPI assigned
Jun 23, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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 25MA08775000 NJ
Hospitalist Physician 208M00000X 25MA08775000 NJ Primary

Addresses

Primary practice location

1925 Pacific Ave
Atlantic City, NJ 08401-6713

Mailing address

1925 Pacific Ave
Atlantic City, NJ 08401-6713
Phone (609) 441-8146

Other identifiers 2

IdentifierTypeStateIssuer
25MA08775000OtherNJPHYSICIAN LICENSE
0240923MedicaidNJ

Other names 1

  • Ezinne Ugochi Nwala Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20100920000412 NJ Practitioner - Internal MedicinePractitioner - Family PracticePractitioner - Peripheral Vascular Disease 8527183177 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mastermind Healthcare LLCGroup PAC ID 4486048873, 3 clinicians
Atlanticare Physician Group PAGroup PAC ID 8527953660, 506 clinicians

Practice addresses (Care Compare)

1925 Pacific Ave
Atlantic City, NJ 08401-6713
Phone (732) 693-1214

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08775000NJMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Sep 1, 2010 Accepting new patients
Atlanticare Physician Group PA Hospitalist CurrentSince Mar 17, 2014 Accepting new patients
Patient Care Medical Group PC CurrentSince Jul 17, 2023 Accepting new patients
Mastermind Healthcare, LLC Internal Medicine CurrentSince Mar 1, 2022 Accepting new patients
Virtua Medical Group, PA Internal Medicine CurrentSince Sep 1, 2010 Accepting new patients
Maez Integrative Healthcare, LLC Internal Medicine CurrentSince Jan 1, 2021 Accepting new patients
Atlanticare Physician Group, PA CurrentSince Mar 17, 2014 Accepting new patients
Acuity Hospital of New Jersey, LLC Past Accepting new patients

Locations

1925 Pacific Ave
Fl 5
Atlantic City, NJ 08401
Phone (609) 441-2122

1925 Pacific Ave
Atlantic City, NJ 08401
Phone (609) 441-8023

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

115 Sunset Rd
Burlington Township, NJ 08016
Phone (609) 387-3620

26 Main St
Edison, NJ 08837
Phone (609) 385-2622

200 New Rd
Linwood, NJ 08221
Phone (609) 354-5553

459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815

65 W Jimmie Leeds Rd
Pomona, NJ 08240
Phone (609) 484-6414

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23733/brand/1/csg/1/fhir/r4

Organizations & group practices 8

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 3

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": "1277251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1457662603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 PACIFIC AVE",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "084016713",
            "telephone_number": "609-441-8146",
            "fax_number": "609-441-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 PACIFIC AVE",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "084016713",
            "telephone_number": "609-441-8146",
            "fax_number": "609-441-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWOTITE",
        "first_name": "EZINNE",
        "middle_name": "UGOCHI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-23",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA08775000",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NJ",
            "license": "25MA08775000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN LICENSE",
            "identifier": "25MA08775000",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0240923",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EZINNE",
            "last_name": "NWALA",
            "middle_name": "UGOCHI",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Atlantic City, NJ

Sources for this page

Verify at the official NPI Registry.