Individual provider Active NPI

Elera Yeye Nwogu, P.A

  • Medical Physician Assistant
  • Glenarden, MD
National Provider Identifier
1497084131
Registry record updated Dec 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA030294 Issued in DC
Practice address
7940 Johnson Ave
Glenarden, MD 20706-1772
Phone
(301) 341-5450
Fax
(301) 341-2424
NPI assigned
Dec 8, 2009
Last updated
Dec 8, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X C0002905 MD
Medical Physician Assistant 363AM0700X PA030294 DC Primary

Addresses

Primary practice location

7940 Johnson Ave
Glenarden, MD 20706-1772

Mailing address

2512 Nicol Cir
Mitchellville, MD 20721-2955
Phone (301) 925-4554

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151123002855 DC Practitioner - Physician Assistant 3870893860

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA030294DCMDMedical Physician Assistant
C0002905MDMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: elera.nwogu@marcelluscephas.chartmakerdirect.com

NPI Registry JSON

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

{
    "created_epoch": "1260230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260230400000",
    "number": "1497084131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2512 NICOL CIR",
            "city": "MITCHELLVILLE",
            "state": "MD",
            "postal_code": "207212955",
            "telephone_number": "301-925-4554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7940 JOHNSON AVE",
            "city": "GLENARDEN",
            "state": "MD",
            "postal_code": "207061772",
            "telephone_number": "301-341-5450",
            "fax_number": "301-341-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWOGU",
        "first_name": "ELERA",
        "middle_name": "YEYE",
        "name_prefix": "Mrs.",
        "credential": "P.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-08",
        "last_updated": "2009-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0002905",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "DC",
            "license": "PA030294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenarden, MD

Sources for this page

Verify at the official NPI Registry.