Active NPI
Elera Yeye Nwogu, P.A
- Medical Physician Assistant
- Glenarden, MD
National Provider Identifier
1497084131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA030294
- 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, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151123002855 | DC | Practitioner - Physician Assistant | 3870893860 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA030294 | DC | MD | Medical Physician Assistant |
| C0002905 | MD | MD | Medical Physician Assistant |
Interoperability endpoints
- 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.