Individual provider Active NPI

Chinwe Christine Madubata, MD

  • Student in an Organized Health Care Education/Training Program
  • New York, NY
National Provider Identifier
1477088276
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
321314 Issued in NY
Practice address
310 E 67TH St
New York, NY 10065-6275
Phone
(646) 908-9908
NPI assigned
Apr 29, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 321314 NY Primary

Addresses

Primary practice location

310 E 67TH St
New York, NY 10065-6275

Mailing address

310 E 67TH St
New York, NY 10065-6275
Phone (646) 908-9908

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20170606001920 PA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 9537436977

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
321314NYMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1493424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1477088276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 E 67TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656275",
            "telephone_number": "646-908-9908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 E 67TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656275",
            "telephone_number": "646-908-9908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADUBATA",
        "first_name": "CHINWE",
        "middle_name": "CHRISTINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-29",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "321314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.