Individual provider Active NPI

Oparaugo Ihentuge Udebiuwa, M.D.

  • Psychiatry Physician
  • Washington, DC
National Provider Identifier
1669693339
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD20259 Issued in DC
Practice address
1221 Taylor Street
Washington, DC 20011
Phone
(202) 464-9200
Fax
(202) 464-5740
NPI assigned
May 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD20259 DC Primary

Addresses

Primary practice location

1221 Taylor Street
Washington, DC 20011

Mailing address

1221 Taylor Street
Washington, DC 20011
Phone (202) 464-9200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD20259DCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cignet Health Uplift Medical Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669693339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 TAYLOR STREET",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20011",
            "telephone_number": "202-464-9200",
            "fax_number": "202-464-5740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 TAYLOR STREET",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20011",
            "telephone_number": "202-464-9200",
            "fax_number": "202-464-5740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDEBIUWA",
        "first_name": "OPARAUGO",
        "middle_name": "IHENTUGE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "DC",
            "license": "MD20259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.