NPIMap

Individual provider Active NPI

Etagbo Oqua Eta, M.D

  • Nephrology Physician
  • Gadsden, AL
National Provider Identifier
1487974630
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD.35051 Issued in AL
Practice address
311 S 4TH St
Gadsden, AL 35901-5212
Phone
(256) 543-0989
NPI assigned
Jun 9, 2010
Last updated
Jan 5, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MD.35051 AL Primary
Internal Medicine Physician 207R00000X MD.35051 AL

Addresses

Primary practice location

311 S 4TH St
Gadsden, AL 35901-5212

Mailing address

PO Box 7190
Rainbow City, AL 35906-7190
Phone (256) 203-4713

Other practice location 1

4802 10th Ave
Brooklyn, NY 11219-2916
Phone (718) 283-6000

Other practice location 2

4802 10th Ave
Brooklyn, NY 11219-2916
Phone (718) 283-6000

Other practice location 3

810 Saint Vincents Dr
Birmingham, AL 35205-1601
Phone (205) 930-2456

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://health.usnews.com/doctors/etagbo-eta-820655

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20170308001133 AL Practitioner - NephrologyPractitioner - Internal MedicinePractitioner - Hospitalist 9931343241 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Hospitalist
Education
Other, 2006
Medicare assignment
May accept Medicare assignment
Group practices
Etagbo Eta MD PCGroup PAC ID 9335575638, 2 clinicians

Practice addresses (Care Compare)

406 Bay St
Gadsden, AL 35901-5108
Phone (256) 203-4713

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.97 of 100Reported as apm
Quality
75.95
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Medicine Associates LLC Internal Medicine CurrentSince Apr 9, 2018 Accepting new patients
Alpha Hospitalist Services CurrentSince Jul 15, 2023 Accepting new patients
Vincentian Physician Services LLC Internal Medicine CurrentSince Jan 1, 2018 Accepting new patients
Alpha Wellness Center and Spa PastSince Jan 21, 2024 Accepting new patients
Allergy Associates, Inc Past Accepting new patients
Doctors Care Physicians PC PastSince Aug 1, 2007 Accepting new patients

Locations

50 Medical Park Dr E
Birmingham, AL 35235
Phone (205) 838-3000

810 Saint Vincents Dr
Birmingham, AL 35205
Phone (205) 930-2456

820 W Washington St
Eufaula, AL 36027
Phone (334) 687-5761

1007 Goodyear Ave
Gadsden, AL 35903
Phone (256) 494-4000

410 Broad St
Gadsden, AL 35901
Phone (256) 438-5107

150 Gilbreath Dr
Oneonta, AL 35121
Phone (205) 274-3000

Organizations & group practices 7

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 10

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": "1276041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1487974630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7190",
            "city": "RAINBOW CITY",
            "state": "AL",
            "postal_code": "359067190",
            "telephone_number": "256-203-4713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 S 4TH ST",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359015212",
            "telephone_number": "256-543-0989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4802 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112192916",
            "country_code": "US",
            "telephone_number": "718-283-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4802 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112192916",
            "country_code": "US",
            "telephone_number": "718-283-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "810 Saint Vincents Dr",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352051601",
            "country_code": "US",
            "telephone_number": "205-930-2456",
            "fax_number": "205-930-2469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ETA",
        "first_name": "ETAGBO",
        "middle_name": "OQUA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-09",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AL",
            "license": "MD.35051",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "MD.35051",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://health.usnews.com/doctors/etagbo-eta-820655",
            "affiliation": "N",
            "address_1": "311 S 4th St",
            "city": "Gadsden",
            "state": "AL",
            "country_code": "US",
            "postal_code": "359015212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gadsden, AL

Sources for this page

Verify at the official NPI Registry.