Individual provider Active NPI

Chidi Iheanacho Anukwuem, M.D.

  • Internal Medicine Physician
  • Irvington, NJ
National Provider Identifier
1487719753
Registry record updated Apr 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA058920 Issued in NJ
Practice address
1182 Stuyvesant Ave
FL. 1
Irvington, NJ 07111-1057
Phone
(973) 399-2600
Fax
(973) 399-5252
NPI assigned
Dec 26, 2006
Last updated
Apr 2, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MA058920 NJ Primary

Addresses

Primary practice location

1182 Stuyvesant Ave
FL. 1
Irvington, NJ 07111-1057

Mailing address

1182 Stuyvesant Ave
FL. 1
Irvington, NJ 07111-1057
Phone (973) 399-2600

Other identifiers 1

IdentifierTypeStateIssuer
6135102MedicaidNJ

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
I20050622000089 NJ Practitioner - Internal Medicine 7416992318 Reassigns benefits to 1 organization
Practice locations: Irvington, NJ

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1182 Stuyvesant Ave
Irvington, NJ 07111-1057
Phone (973) 224-4317

Hospital & facility affiliations

  • Patient Care Home health agency, West Orange, NJ, CCN 317060

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA058920NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anukwuem Enterprises, Inc Current Accepting new patients
Sciometrix Inc CurrentSince Feb 15, 2024 Accepting new patients
University Hospital Past Accepting new patients
Newark Beth Israel Medical Center Inc Past Accepting new patients
Sciometrix LLC PastSince Oct 10, 2021 Accepting new patients

Locations

306 S Washington Ave
Ste 600
Royal Oak, MI 48067

1182 Stuyvesant Ave
#1
Irvington, NJ 07111
Phone (973) 399-2600

5600 Kennedy Blvd W
West New York, NJ 07093
Phone (201) 686-3100

Interoperability endpoints

  • Direct secure messaging: canukwuem260311@epicdirect.rwjbh.org
  • Direct secure messaging: chidi.anukwuem@glacecentral.com

Organizations & group practices 6

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 1

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": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396396800000",
    "number": "1487719753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1182 STUYVESANT AVE",
            "address_2": "FL. 1",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071111057",
            "telephone_number": "973-399-2600",
            "fax_number": "973-399-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1182 STUYVESANT AVE",
            "address_2": "FL. 1",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071111057",
            "telephone_number": "973-399-2600",
            "fax_number": "973-399-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANUKWUEM",
        "first_name": "CHIDI",
        "middle_name": "IHEANACHO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-26",
        "last_updated": "2014-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA058920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6135102",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvington, NJ

Sources for this page

Verify at the official NPI Registry.