Ikechukwu Okereke

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

P105709 Issued in NY

Practice address

1 Bay Avenue
Montclair, NJ 07042-2033

Phone

(973) 429-6000

NPI assigned

Jul 8, 2020

Last updated

Jun 25, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, NJ2 enrollments

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 2

Specialty

Internal Medicine

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Primary Care PCGroup PAC ID 5991098493, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: iokereke868705@ahs.direct-ci.com

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.

• Community Primary Care, PC

  • Primary Care Clinic/Center
  • Jersey City, NJ
  • NPI 1821452053
  Medicare reassignment Care Compare group
• Internal Medicine Solutions P.C.

  • Internal Medicine Physician
  • Woodside, NY
  • NPI 1467821694
  Medicare reassignment

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687651200000",
    "number": "1639797418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 BEACH 20TH ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116913615",
            "telephone_number": "718-327-7307",
            "fax_number": "718-327-3294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BAY AVENUE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422033",
            "telephone_number": "973-429-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKEREKE",
        "first_name": "IKECHUKWU",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-08",
        "last_updated": "2023-06-25",
        "certification_date": "2023-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "105709-01",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "P105709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oasis Behavioral Health & Addiction Services
• Paula C Ochs, LCSW
• Obinnaya Odigboegwu, MD
• Odyssey Emergency Physicians, LLC
• Sae Eun Oh, MA, MHC-LP
• Uchenna Kelenna Okoji, MD
• Jennifer Okorie, PT, DPT
• Belgin Olgun
• Carole A Oliver, LPC
• Iyinoluwa Oluwatola, LCSW, LCADC

• Internal Medicine Physician in Montclair, NJ
• Providers in Montclair, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2023; 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.