NPIMap

Individual provider Active NPI

Solibe Chikaodili Ufondu, MD

  • Family Medicine Physician
  • East Stroudsburg, PA
National Provider Identifier
1548232523
Registry record updated Oct 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD062479L Issued in PA
Practice address
302 E Brown St
Ste a
East Stroudsburg, PA 18301
Phone
(570) 476-4161
Fax
(570) 476-9954
NPI assigned
Feb 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD062479L PA Primary

Addresses

Primary practice location

302 E Brown St
Ste a
East Stroudsburg, PA 18301

Mailing address

302 E Brown St
Ste a
East Stroudsburg, PA 18301-3010
Phone (570) 476-4161

Other identifiers 1

IdentifierTypeStateIssuer
0017527430004MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20110121000512 PA Practitioner - Family Practice 1456530583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

302 E Brown St
Suite a
East Stroudsburg, PA 18301-3010
Phone (570) 476-4161

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pocono Adult & Pediatric Medical Group LLC Family Medicine CurrentSince Jan 4, 1999 Accepting new patients
Stroudsburg Post Acute Nursing & Rehabilitation LLC Past Accepting new patients
Pleasant Valley Manor, Inc. Past Accepting new patients

Locations

302 E Brown St
Ste A
East Stroudsburg, PA 18301
Phone (570) 476-4161

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11514/brand/1/csg/1/fhir/r4
  • Direct secure messaging: sufondu234627@direct2.lvhn.org

Organizations & group practices 3

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": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1548232523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 E BROWN ST",
            "address_2": "STE A",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183013010",
            "telephone_number": "570-476-4161",
            "fax_number": "570-476-9808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 E BROWN ST",
            "address_2": "STE A",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "18301",
            "telephone_number": "570-476-4161",
            "fax_number": "570-476-9954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UFONDU",
        "first_name": "SOLIBE",
        "middle_name": "CHIKAODILI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD062479L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017527430004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Stroudsburg, PA

Sources for this page

Verify at the official NPI Registry.