NPIMap

Individual provider Active NPI

Obiageli Chinaka Ezewuiro, MD

  • Hematology & Oncology Physician
  • El Paso, TX
National Provider Identifier
1518128149
Registry record updated Jan 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
S6610 Issued in TX
Practice address
7848 Gateway Blvd E
El Paso, TX 79915-1815
Phone
(915) 599-1313
Fax
(915) 599-1701
NPI assigned
Jun 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 11013729A IL
Hematology & Oncology Physician 207RH0003X 01069645A IN
Medical Oncology Physician 207RX0202X TP954 KY
Hematology & Oncology Physician 207RH0003X S6610 TX Primary

Addresses

Primary practice location

7848 Gateway Blvd E
El Paso, TX 79915-1815

Mailing address

PO Box 911230
Dallas, TX 75391-1230
Phone (972) 997-8000

Other identifiers 1

IdentifierTypeStateIssuer
417903801MedicaidTX

Other names 1

  • Obiageli Chinaka Ntukogu Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20200827000387 TX Practitioner - Hematology/Oncology 6406171057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Oncology PAGroup PAC ID 5395658934, 1,001 clinicians

Practice addresses (Care Compare)

7848 Gateway Blvd E
El Paso, TX 79915-1815
Phone (915) 599-1313

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.12 of 100Reported as apm
Quality
67.48
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11013729AILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Oncology PA Hematology & Oncology CurrentSince Aug 1, 2020 Accepting new patients
Texas Oncology PA Hematology & Oncology CurrentSince Aug 1, 2020 Accepting new patients

Locations

3270 Joe Battle Blvd
Ste 312
El Paso, TX 79938
Phone (915) 747-4877

1901 Grandview Ave
El Paso, TX 79902
Phone (915) 544-6750

7848 Gateway Blvd E
El Paso, TX 79915
Phone (915) 599-1313

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

Interoperability endpoints

  • Direct secure messaging: obiageli.ezewuiro@txo.ikm.direct-ci.com

Organizations & group practices 2

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 7

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": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610064000000",
    "number": "1518128149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 911230",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753911230",
            "telephone_number": "972-997-8000",
            "fax_number": "972-234-2987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7848 GATEWAY BLVD E",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799151815",
            "telephone_number": "915-599-1313",
            "fax_number": "915-599-1701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZEWUIRO",
        "first_name": "OBIAGELI",
        "middle_name": "CHINAKA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-17",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "11013729A",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IN",
            "license": "01069645A",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "KY",
            "license": "TP954",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "TX",
            "license": "S6610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "417903801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OBIAGELI",
            "last_name": "NTUKOGU",
            "middle_name": "CHINAKA",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.