Prince Osazuwa Ehimamiegho, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A202757 Issued in CA

Practice address

815 Main St Ste C
Peoria, IL 61602-1080

Phone

(309) 672-4977

NPI assigned

Apr 22, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, CA2 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 2

Specialty

Family Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northbay Health Medical FoundationGroup PAC ID 3274010871, 207 clinicians

Northbay Physicians Surgery Center, LLCGroup PAC ID 0042122244, 336 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Healthflex Home Health Services Home health agency, Oakland, CA, CCN 059551
• Accentcare Home Health of California, Inc Home health agency, San Ramon, CA, CCN 057517
• Mission Home Health of Contra Costa Home health agency, Concord, CA, CCN 059536
• Northbay Medical Center Hospital, Fairfield, CA, CCN 050367

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/UMZ-Uxn6V9x08sH5gCnG-5yPg9ZX7et6/
• Direct secure messaging: pehimamieghomd388624@carlehiedirect.net

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.

• Northbay Health Medical Foundation

  • Internal Medicine Physician
  • Fairfield, CA
  • NPI 1760283527

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Northbay Healthcare Group

  • General Acute Care Hospital
  • Fairfield, CA
  • NPI 1821147786
  Medicare reassignment Care Compare group NPD
• Methodist Medical Center of Illinois

  • Rehabilitation Hospital Unit
  • Peoria, IL
  • NPI 1982656575
  Medicare reassignment NPD
• Methodist Medical Center of Illinois

  • General Acute Care Hospital
  • Peoria, IL
  • NPI 1164474755
  NPD
• Northbay Healthcare Group

  • Multi-Specialty Clinic/Center
  • Vacaville, CA
  • NPI 1760534713
  NPD
• Northbay Physicians Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Vacaville, CA
  • NPI 1003015843
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Accentcare Home Health of California, Inc.

  • Home Health Agency
  • San Ramon, CA
  • NPI 1972559961
  Care Compare affiliation
• Healthflex Home Health Services

  • Home Health Agency
  • Oakland, CA
  • NPI 1326399296
  Care Compare affiliation
• Healthy Living at Home East Bay LLC

  • Home Health Agency
  • Concord, CA
  • NPI 1538411632
  Care Compare affiliation
• Northbay Healthcare Group

  • General Acute Care Hospital
  • Fairfield, CA
  • NPI 1821147786
  Care Compare affiliation

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

{
    "created_epoch": "1650585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1497499719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9466 MOURVERDE CT",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956244611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 MAIN ST STE C",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021080",
            "telephone_number": "309-672-4977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHIMAMIEGHO",
        "first_name": "PRINCE",
        "middle_name": "OSAZUWA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-22",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A202757",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036172524",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alison B Eeten, CNP
• Marilyn S. Eeten, COTA
• Jill M Egizio, LCSW
• Charles Egley, MD
• Peter Egwom, MD
• Alyssa Joann Ehnle, OTR/L
• Mikell Ryanne Ehnle, PSYD
• Robert R. Ehrich, D.D.S.
• Bazal Ehsan
• Kathleen Rose Eichinger, M.D.

• Family Medicine Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2025; 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.
• 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.