Individual provider Active NPI

Kelechi Akuma, MD

  • Vascular Surgery Physician
  • Bay Shore, NY
National Provider Identifier
1649539339
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
155660 Issued in FL
Practice address
250 E Main St
Bay Shore, NY 11706-8442
Phone
(631) 470-1460
NPI assigned
May 15, 2012
Last updated
Apr 26, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 284878 NY
Vascular Surgery Physician 2086S0129X 155660 FL Primary

Addresses

Primary practice location

250 E Main St
Bay Shore, NY 11706-8442

Mailing address

250 E Main St
Bay Shore, NY 11706-8442
Phone (631) 470-1460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20220510002558 FL Practitioner - Vascular Surgery 5496008930 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palm Beach General Surgery LLCGroup PAC ID 1456455021, 69 clinicians

Practice addresses (Care Compare)

7421 N University Dr
Suite 107
Tamarac, FL 33321-2952
Phone (954) 726-0095

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Promoting interoperability
98
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
155660FLMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Palm Beach General Surgery LLC Surgery CurrentSince Jul 1, 2022 Accepting new patients
Lawnwood Cardiovascular Surgery LLC CurrentSince Jul 1, 2022 Accepting new patients
Thoracic & Cardiovascular Surgeons LLC Past Accepting new patients
Palm Beach General Surgery LLC Surgery Past Accepting new patients

Locations

5301 S Congress Ave
Bldg 300
Atlantis, FL 33462
Phone (561) 548-4900

12953 Palms West Dr
Ste 201
Loxahatchee, FL 33470
Phone (561) 790-2111

1825 SE Tiffany Ave
Ste 101
Port St Lucie, FL 34952
Phone (772) 219-4026

7421 N University Dr
Ste 107
Tamarac, FL 33321
Phone (954) 724-3400

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: kelechi.akuma@hca4.eclinicaldirectplus.com
  • Direct secure messaging: kelechiakuma@nslijmedgr.allscriptsdirect.net

Organizations & group practices 4

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 2

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": "1337040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1649539339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068442",
            "telephone_number": "631-470-1460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068442",
            "telephone_number": "631-470-1460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKUMA",
        "first_name": "KELECHI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-15",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "284878",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "155660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.