Gloria Ozioma Ibezim, FAMILY NURSE PRACT

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F08170262 Issued in NY

Practice address

620 Westfall Rd
Rochester, NY 14620-4610

Phone

(585) 461-8580

NPI assigned

Sep 2, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• State of New York Comptrollers Office

  • Developmental Disabilities Clinic/Center
  • Staten Island, NY
  • NPI 1750469912
  Medicare reassignment NPD
• State of New York Comptrollers Office

  • Physical Therapist
  • Albany, NY
  • NPI 1346710985
  NPD

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

{
    "created_epoch": "1346544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1649529900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 AMBERLY CIR",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146242602",
            "telephone_number": "585-354-9628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 WESTFALL RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146204610",
            "telephone_number": "585-461-8580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Amberly Cir",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146242602",
            "country_code": "US",
            "telephone_number": "585-426-1476",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "620 Westfall Rd",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146204610",
            "country_code": "US",
            "telephone_number": "585-461-8580 x8583",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBEZIM",
        "first_name": "GLORIA",
        "middle_name": "OZIOMA",
        "name_prefix": "Mrs.",
        "credential": "FAMILY  NURSE PRACT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-02",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "574544",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F08170262",
            "primary": false
        },
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "NY",
            "license": "FO8170262",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F08170262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1649529900",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin G. Ibach, M.D.
• Diana Holland Ibanez, ACNP-C
• Ibero American Action League, Inc.
• Ibero American Action Lueage, Inc.
• Cecilia Chinenye Ibezim, LPN
• Ahmed Sayed Ibrahim, MBBS
• Andrew Ibrahim, MD
• Gasser Hesham Saad Ibrahim, BDS
• George Ibrahim, MD
• Sajjad Ahmad Ibrar, M.D.

• Family Nurse Practitioner in Rochester, NY
• Providers in Rochester, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.