NPIMap

Individual provider Active NPI

Izu E Nwakoby, M.D.

  • Nephrology Physician
  • Ocala, FL
National Provider Identifier
1629076419
Registry record updated Sep 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME85083 Issued in FL
Practice address
2980 SE 3Rd CT
Ocala, FL 34471-0421
Phone
(352) 622-4231
Fax
(352) 622-0513
NPI assigned
Jul 14, 2005
Reactivated
Mar 31, 2006
Last updated
Sep 25, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X ME85083 FL Primary

Addresses

Primary practice location

2980 SE 3Rd CT
Ocala, FL 34471-0421

Mailing address

2980 SE 3Rd CT
Ocala, FL 34471-0421
Phone (352) 622-4231

Other identifiers 3

IdentifierTypeStateIssuer
110237945OtherFLRRMC (IND)
265030400MedicaidFL
CD4677OtherFLRRMC (GRP)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100811000896 FL Practitioner - NephrologyPractitioner - Internal Medicine 0244314987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ocala Kidney Group IncGroup PAC ID 5092795054, 13 clinicians

Practice addresses (Care Compare)

2980 SE 3Rd CT
Ocala, FL 34471-0421
Phone (352) 622-4231

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ocala Kidney Group Inc Nephrology CurrentSince Jul 25, 2021 Accepting new patients
Screven Dialysis, LLC PastSince Nov 19, 2021 Accepting new patients

Locations

2980 SE 3rd Ct
Ocala, FL 34471
Phone (352) 622-4231

2980 SE 3rd Ct
Ste N
Ocala, FL 34471
Phone (352) 622-4231

8613 SW 103rd Street Rd
Ocala, FL 34481
Phone (352) 622-4231

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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 9

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": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222300800000",
    "number": "1629076419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 SE 3RD CT",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344710421",
            "telephone_number": "352-622-4231",
            "fax_number": "352-622-0513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2980 SE 3RD CT",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344710421",
            "telephone_number": "352-622-4231",
            "fax_number": "352-622-0513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWAKOBY",
        "first_name": "IZU",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2008-09-25",
        "deactivation_date": "2006-03-17",
        "reactivation_date": "2006-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME85083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC (IND)",
            "identifier": "110237945",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "265030400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC (GRP)",
            "identifier": "CD4677",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

Verify at the official NPI Registry.