NPIMap

Individual provider Active NPI

Kingsley Ikenna Onuoha, MD

  • Internal Medicine Physician
  • Gallup, NM
National Provider Identifier
1497384853
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD2024-1130 Issued in NM
Practice address
1551 S Second St
Gallup, NM 87301-5881
Phone
(505) 863-7993
NPI assigned
Apr 7, 2020
Last updated
Jun 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NM
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X MD2024-1130 NM Primary

Addresses

Primary practice location

1551 S Second St
Gallup, NM 87301-5881

Mailing address

2800 Main Street
Department of Medicine
Bridgeport, CT 06606-4201
Phone (475) 210-5791

Other practice location 1

1 University of New Mexico
Albuquerque, NM 87131-0001
Phone (505) 272-4661

Other practice location 2

2800 Main Street
Department Of Medicine
Bridgeport, CT 06606-4201
Phone (475) 210-5791

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20250423003720 NM Practitioner - HospitalistPractitioner - Nephrology 4284094541 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Nephrology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
High Desert Nephrology Associates PLLCGroup PAC ID 5092877696, 7 clinicians
Rehoboth McKinley Christian Health Care Services, Inc.Group PAC ID 1759293855, shared by 3 NPIs, 31 clinicians

Practice addresses (Care Compare)

1551 S 2ND St
Gallup, NM 87301-5881
Phone (505) 863-7993

1901 Red Rock Dr
Gallup, NM 87301-5683
Phone (505) 863-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2024-1130NMMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
High Desert Nephrology Associates PLLC CurrentSince Apr 21, 2025 Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc Internal Medicine CurrentSince Apr 21, 2025 Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc CurrentSince Apr 21, 2025 Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc. Current Accepting new patients

Locations

1551 S Second St
Gallup, NM 87301
Phone (505) 542-0090

1801 Red Rock Dr
Gallup, NM 87301
Phone (505) 863-7933

1901 Red Rock Dr
Gallup, NM 87301
Phone (505) 863-7000

Interoperability endpoints

  • Direct secure messaging: konuoha591862@direct.ochin.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1497384853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 MAIN STREET",
            "address_2": "DEPARTMENT OF MEDICINE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064201",
            "telephone_number": "475-210-5791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 S SECOND ST",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015881",
            "telephone_number": "505-863-7993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 University of New Mexico",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871310001",
            "country_code": "US",
            "telephone_number": "505-272-4661",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2800 Main Street",
            "address_2": "Department Of Medicine",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "CT",
            "postal_code": "066064201",
            "country_code": "US",
            "telephone_number": "475-210-5791",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ONUOHA",
        "first_name": "KINGSLEY",
        "middle_name": "IKENNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-07",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "MD2024-1130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallup, NM

Sources for this page

Verify at the official NPI Registry.