Individual provider Active NPI

Ijeoma Florence Ozigbo, RPA-C

  • Physician Assistant
  • Helotes, TX
National Provider Identifier
1679595441
Registry record updated Dec 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA04579 Issued in TX
Practice address
12030 Bandera Rd Ste 128
Helotes, TX 78023-4776
Phone
(121) 047-3421
Fax
(877) 453-5811
NPI assigned
Jul 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA04579 TX Primary
Physician Assistant 363A00000X 008110 NY

Addresses

Primary practice location

12030 Bandera Rd Ste 128
Helotes, TX 78023-4776

Mailing address

12030 Bandera Rd Ste 128
Helotes, TX 78023-4776
Phone (210) 473-4211

Other names 1

  • Ijeoma Florence Madu Other name

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20080619000496 TX Practitioner - Physician Assistant 1658314216 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA04579TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Holisticvision LLC PastSince Mar 3, 2021 Accepting new patients
Park Slope Emergency Physician Services, PC Past Accepting new patients

Organizations & group practices 3

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703980800000",
    "number": "1679595441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12030 BANDERA RD STE 128",
            "city": "HELOTES",
            "state": "TX",
            "postal_code": "780234776",
            "telephone_number": "210-473-4211",
            "fax_number": "877-453-5811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12030 BANDERA RD STE 128",
            "city": "HELOTES",
            "state": "TX",
            "postal_code": "780234776",
            "telephone_number": "121-047-3421",
            "fax_number": "877-453-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OZIGBO",
        "first_name": "IJEOMA",
        "middle_name": "FLORENCE",
        "name_prefix": "Mrs.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2023-12-31",
        "certification_date": "2023-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04579",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "008110",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IJEOMA",
            "last_name": "MADU",
            "middle_name": "FLORENCE",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Helotes, TX

Sources for this page

Verify at the official NPI Registry.