Ebehireme E Ibazebo, M.D

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

125065062 Issued in IL

Practice address

1227 E Rusholme St
Davenport, IA 52803-2459

Phone

(563) 421-3120

Fax

(563) 421-3129

NPI assigned

Jun 26, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in PA

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

HospitalistAlso: Internal Medicine

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Phoenixville Clinic Company LLCGroup PAC ID 5799796850, 135 clinicians

Clinical Care Associates of the University of Pennsylvania Health.Group PAC ID 4688588866, 591 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Main Line Health Homecare & Hospice - Hospice Hospice, Radnor, PA, CCN 391583
• Paoli Hospital Hospital, Paoli, PA, CCN 390153
• Riddle Memorial Hospital Hospital, Media, PA, CCN 390222
• Phoenixville Hospital Hospital, Phoenixville, PA, CCN 390127
• Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1606/brand/1/csg/101/fhir/r4
• Direct secure messaging: ebehireme.ibazebo@direct.genesishealth.com
• Direct secure messaging: ibazeboee@genesishealth.com

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.

• Clinical Care Associates of the University of Pennsylvania Health

  • Internal Medicine Physician
  • Radnor, PA
  • NPI 1972682995
  Medicare reassignment Care Compare group NPD
• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Phoenixville Clinic Company LLC

  • Family Medicine Physician
  • Phoenixville, PA
  • NPI 1891866182
  Medicare reassignment Care Compare group NPD
• Trinity Health Mid-Atlantic Medical Group

  • Surgery Physician
  • Langhorne, PA
  • NPI 1972982361
  Medicare reassignment NPD
• Clinical Care Associates of the University of Pennsylvania Health

  • Psychologist
  • West Chester, PA
  • NPI 1649940107
  NPD
• Phoenixville Clinic Company LLC

  • Neurology Physician
  • Phoenixville, PA
  • NPI 1275173957
  NPD
• Phoenixville Clinic Company LLC

  • Vascular Surgery Physician
  • Limerick, PA
  • NPI 1790746345
  NPD
• Trinity Health Mid-Atlantic Medical Group

  • Physical Medicine & Rehabilitation Physician
  • Philadelphia, PA
  • NPI 1639039175
  NPD
• Trinity Health Mid-Atlantic Medical Group

  • Family Medicine Physician
  • Langhorne, PA
  • NPI 1932515533
  NPD
• Clinical Care Associates of the University of Pennsylvania Health Syst

  • Hospitalist Physician
  • Bala Cynwyd, PA
  • NPI 1790737468

  Internal Medicine

  NPD (past)
• Main Line Hospitals, Inc.

  • General Acute Care Hospital
  • Paoli, PA
  • NPI 1215042114
  NPD (past)
• Riddle Memorial Hospital

  • General Acute Care Hospital
  • Media, PA
  • NPI 1407856099
  NPD (past)

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

• Main Line Health Homecare and Hospice

  • Community Based Hospice Care Agency
  • Radnor, PA
  • NPI 1881629228
  Care Compare affiliation Name & address match
• Main Line Hospitals, Inc.

  • General Acute Care Hospital
  • Paoli, PA
  • NPI 1215042114
  Care Compare affiliation
• Main Line Hospitals, Inc.

  • General Acute Care Hospital
  • Wynnewood, PA
  • NPI 1245335629
  Care Compare affiliation
• Phoenixville Hospital, LLC

  • General Acute Care Hospital
  • Phoenixville, PA
  • NPI 1750805552
  Care Compare affiliation
• Riddle Memorial Hospital

  • General Acute Care Hospital
  • Media, PA
  • NPI 1407856099
  Care Compare affiliation

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

{
    "created_epoch": "1403740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1639584733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5522 EMILY RD",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527221260",
            "telephone_number": "832-774-5925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 E RUSHOLME ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528032459",
            "telephone_number": "563-421-3120",
            "fax_number": "563-421-3129"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 W Harrison St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123714",
            "country_code": "US",
            "telephone_number": "312-864-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBAZEBO",
        "first_name": "EBEHIREME",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-26",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125065062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "IbazeboeE@genesishealth.com",
            "affiliation": "N",
            "endpointDescription": "Genesis Health System Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1227 E Rusholme St",
            "city": "Davenport",
            "state": "IA",
            "country_code": "US",
            "postal_code": "528032459",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ebehireme.ibazebo@direct.genesishealth.com",
            "affiliation": "N",
            "endpointDescription": "Genesis Health System Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1227 E Rusholme St",
            "city": "Davenport",
            "state": "IA",
            "country_code": "US",
            "postal_code": "528032459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hy-Vee Inc
• Hy-Vee Inc
• Hy-Vee Inc
• Nathaniel Hyatt, DMD
• Roger Jonathan Hynes, D.C.
• Kelsey Ibeawuchi, PHARMD
• Ideal Health and Wellness, SC
• David R Iglehart, DDS
• Olaitan Atinuke Ijitimehin, MD
• Ali Ilahi, MD

• Internal Medicine Physician in Davenport, IA
• Providers in Davenport, IA by specialty
• Internal Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; 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.