Lisa Chinweifenu Ezegbu, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA11406000 Issued in NJ

Practice address

2015 Pacific Ave
Atlantic City, NJ 08401-6726

Phone

(609) 449-4391

NPI assigned

Jul 22, 2019

Last updated

Oct 6, 2022By the provider in NPPES

Sex

Female

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 NJ

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 1

Specialty

Internal Medicine

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Atlanticare Health Services, Inc.Group PAC ID 7911810916, 56 clinicians

Atlanticare Physician Group PAGroup PAC ID 8527953660, 506 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Atlanticare Regional Medical Center - City Campus Hospital, Atlantic City, NJ, CCN 310064

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Atlanticare Health Services, Inc.

  • Clinic/Center
  • Atlantic City, NJ
  • NPI 1215987771
  Medicare reassignment Care Compare group NPD
• Atlanticare Physician Group PA

  • Clinic/Center
  • Egg Harbor Township, NJ
  • NPI 1093829608
  Medicare reassignment Care Compare group NPD
• Atlanticare Health Services Inc.

  • Federally Qualified Health Center (FQHC)
  • Atlantic City, NJ
  • NPI 1679148712
  NPD
• Atlanticare Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Egg Harbor Township, NJ
  • NPI 1407617947
  NPD
• Atlanticare Physician Group, PA

  dba AtlantiCare Urgent Care

  • Urgent Care Clinic/Center
  • Galloway, NJ
  • NPI 1003820622
  NPD
• Atlanticare Regional Medical Center

  • General Acute Care Hospital
  • Pomona, NJ
  • NPI 1013919315
  NPD (past)

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

• Atlanticare Regional Medical Center

  • General Acute Care Hospital
  • Pomona, NJ
  • NPI 1013919315
  Care Compare affiliation

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

{
    "created_epoch": "1563753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1508419292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 PACIFIC AVE",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "084016726",
            "telephone_number": "609-449-4391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 PACIFIC AVE",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "084016726",
            "telephone_number": "609-449-4391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZEGBU",
        "first_name": "LISA",
        "middle_name": "CHINWEIFENU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-22",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA11406000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Erb
• Akhmad Ernazarov, DO
• Tamara Sonya Etheridge
• Karen Everett
• Evernorth Direct Health LLC
• Muhammad Farhan, MD
• Marie Farnsworth
• Mohammad Ahmad Hassan Farooq, MD
• Michael Domenic Farreny, PMHNP
• Viviana Faunce, AGPCNP-BC

• Internal Medicine Physician in Atlantic City, NJ
• Providers in Atlantic City, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; 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.