Chuka Victor Ifeanyi, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

206975 Issued in LA

Practice address

1455 E Bert Koun Loop
#206
Shreveport, LA 71105-5634

Phone

(318) 798-4464

Fax

(318) 798-4529

NPI assigned

Jun 19, 2009

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in LA

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

Otolaryngology

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Highland Clinic, a Prof Med CorpGroup PAC ID 3870493463, 60 clinicians

Cornerstone Therapy and Balance Center, LLCGroup PAC ID 0345397899, 98 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Coushatta, LA, CCN 197334
• Christus Shreveport-Bossier Health System Hospital, Shreveport, LA, CCN 190041
• Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111

Merit-based Incentive Payment System (MIPS)

Final score

78.6 of 100Reported as group

Quality

58.23

Promoting interoperability

97

Improvement activities

40

Cost

72.94

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: chuka.ifeanyi.p1@direct.hcapmc.nextgenshare.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.

• Highland Clinic, a Prof Med Corp

  • Multi-Specialty Clinic/Center
  • Shreveport, LA
  • NPI 1053315846
  Medicare reassignment Care Compare group NPD
• Cornerstone Therapy and Balance Center, LLC

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Shreveport, LA
  • NPI 1659518041
  Care Compare group
• Highland Clinic, a Prof Med Corp

  • Orthopaedic Surgery Physician
  • Bossier City, LA
  • NPI 1740897743
  NPD

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

• Christus Health Northern Louisiana

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1417950106
  Care Compare affiliation
• Synergy Home Care Northwestern Region Inc

  • Home Health Agency
  • Coushatta, LA
  • NPI 1982696217
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Bossier City, LA
  • NPI 1003968579
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1124170691
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1275685539
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1568461572
  Care Compare affiliation

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

{
    "created_epoch": "1245369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1649407487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 E BERT KOUN LOOP",
            "address_2": "#206",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055634",
            "telephone_number": "318-798-4464",
            "fax_number": "318-798-4529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 E BERT KOUN LOOP",
            "address_2": "#206",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055634",
            "telephone_number": "318-798-4464",
            "fax_number": "318-798-4529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IFEANYI",
        "first_name": "CHUKA",
        "middle_name": "VICTOR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-19",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IA",
            "license": "R-8725",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "LA",
            "license": "206975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2370146",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chuka.ifeanyi.p1@direct.hcapmc.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1455 E Bert Koun Loop",
            "address_2": "#206",
            "city": "Shreveport",
            "state": "LA",
            "country_code": "US",
            "postal_code": "711055634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Abubakar Denja Ibrahim, MD
• Ammoura Mohammed Ibrahim, M.B.CH.B
• Hassan Mohwad Ibrahim, M.D.
• Nasreldin Mohamed Ibrahim, MD
• Icp Louisiana Aco Billing LLC
• Amal Ifikhar, MD
• Jazeb Ifikhar
• Patrick Igbokwe, PHARMD
• Ihab John Ibrahim MD LLC
• Priscilla Ihenacho, MD

• Otolaryngology Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Otolaryngology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; 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.