Active NPI
Chisom Dominic Okezue
- Internal Medicine Physician
- Mount Vernon, NY
National Provider Identifier
1598407793
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 339600
- Practice address
- 12 N 7TH Ave
Mount Vernon, NY 10550-2026 - Phone
- (914) 664-8000
- NPI assigned
- Apr 8, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 339600 | NY | Primary |
Addresses
Primary practice location
12 N 7TH Ave
Mount Vernon, NY 10550-2026
Mailing address
11043 173Rd St
Jamaica, NY 11433-3438
Phone (347) 229-6353
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12 N 7TH Ave
Mount Vernon, NY 10550-2026
Phone (914) 664-8000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 339600 | NY | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montefiore Mount Vernon Hospital | Past | Accepting new patients |
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.
-
- Internal Medicine Physician
- East Patchogue, NY
- NPI 1912941238
-
- General Acute Care Hospital
- Mount Vernon, NY
- NPI 1992131320
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bronx, NY
- NPI 1952476988
-
- General Acute Care Hospital
- Mount Vernon, NY
- NPI 1992131320
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759449600000",
"number": "1598407793",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11043 173RD ST",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114333438",
"telephone_number": "347-229-6353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 N 7TH AVE",
"city": "MOUNT VERNON",
"state": "NY",
"postal_code": "105502026",
"telephone_number": "914-664-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OKEZUE",
"first_name": "CHISOM",
"middle_name": "DOMINIC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-04-08",
"last_updated": "2025-10-03",
"certification_date": "2025-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "339600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mount Vernon, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.