Individual provider Active NPI

Ikenna Chimaeze Ogobuiro, DNP, MBA, CRNA, APRN

  • Certified Registered Nurse Anesthetist
  • Fort Worth, TX
National Provider Identifier
1497367882
Registry record updated Jul 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1166576 Issued in TX
Practice address
1761 Placitas TRL
Fort Worth, TX 76131-1506
Phone
(214) 874-8516
NPI assigned
Aug 18, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 845025 TX
Certified Registered Nurse Anesthetist 367500000X 1166576 TX Primary

Addresses

Primary practice location

1761 Placitas TRL
Fort Worth, TX 76131-1506

Mailing address

1761 Placitas TRL
Fort Worth, TX 76131-1506
Phone (214) 874-8516

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240903000855 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 6002355203 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McAllen Anesthesia Consultants PAGroup PAC ID 3476512377, 49 clinicians
Renaissance Specialist ClinicGroup PAC ID 4284111691, 38 clinicians

Practice addresses (Care Compare)

5501 S McColl Rd
Edinburg, TX 78539-5503
Phone (956) 661-0529

Hospital & facility affiliations

  • Doctors Hosptal at Renaissance Hospital, Edinburg, TX, CCN 450869

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration

State licenses

LicenseStateTypeSpecialty
845025TXMDCritical Care Medicine Registered Nurse
1166576TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
McAllen Anesthesia Consultants, PA Current Accepting new patients
Renaissance Medical Foundation Current Accepting new patients
Renaissance Specialist Clinic CurrentSince Feb 1, 2026 Accepting new patients
McAllen Anesthesia Consultants, PA CurrentSince Jul 10, 2024 Accepting new patients

Locations

5501 S McColl Rd
Edinburg, TX 78539
Phone (956) 362-3300

5415 S McColl Rd
Edinburg, TX 78539
Phone (956) 661-0529

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722124800000",
    "number": "1497367882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1761 PLACITAS TRL",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761311506",
            "telephone_number": "214-874-8516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1761 PLACITAS TRL",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761311506",
            "telephone_number": "214-874-8516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGOBUIRO",
        "first_name": "IKENNA",
        "middle_name": "CHIMAEZE",
        "name_prefix": "Dr.",
        "credential": "DNP, MBA, CRNA, APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-18",
        "last_updated": "2024-07-28",
        "certification_date": "2024-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "TX",
            "license": "845025",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "1166576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.