Individual provider Active NPI

Chiamaka Agbasionwe

  • Pediatrics Physician
  • New York, NY
National Provider Identifier
1497218127
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
319037 Issued in NY
Practice address
1178 Broadway FL 3
New York, NY 10001-5666
Phone
(845) 276-3847
NPI assigned
Apr 10, 2019
Last updated
Jan 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 319037 NY Primary

Addresses

Primary practice location

1178 Broadway FL 3
New York, NY 10001-5666

Mailing address

1178 Broadway FL 3
New York, NY 10001-5666
Phone (845) 276-3847

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CT, NY3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20240131002602 TX Practitioner - Pediatric Medicine 2668825100 Reassigns benefits to 1 organization
I20240924001010 CT Practitioner - Pediatric Medicine 2668825100 Reassigns benefits to 1 organization
I20241220002908 NY Practitioner - Pediatric Medicine 2668825100 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
319037NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center Pediatrics CurrentSince Sep 13, 2024 Accepting new patients
Stamford Health Medical Group Inc CurrentSince Oct 1, 2024 Accepting new patients
Montefiore Medical Center CurrentSince Sep 13, 2024 Accepting new patients
Arctic Slope Native Association LTD Current Accepting new patients
Meldcare PLLC Pediatrics Current Accepting new patients
Montefiore New Rochelle Hospital Past Accepting new patients

Locations

1 Hospital Plz
Stamford, CT 06902
Phone (203) 276-4925

5 High Ridge Park
Ste 103
Stamford, CT 06905
Phone (203) 276-4644

111 E 210th St
Bronx, NY 10467

16 Guion Pl
New Rochelle, NY 10801
Phone (914) 365-3680

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: cagbasionwe26522@stamfordhealth.direct-ci.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/ABCIBA

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.

NPI Registry JSON

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1497218127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1178 BROADWAY FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100015666",
            "telephone_number": "845-276-3847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1178 BROADWAY FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100015666",
            "telephone_number": "845-276-3847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGBASIONWE",
        "first_name": "CHIAMAKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-10",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "319037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.