Individual provider Active NPI

Uzoma Kelechi Nwaubani, M.D

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Wildwood, FL
National Provider Identifier
1679734453
Registry record updated Jun 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
License
ME105721 Issued in FL
Practice address
9580 N US Highway 301
Wildwood, FL 34785-8772
Phone
(352) 633-0703
Fax
(352) 399-2168
NPI assigned
Jun 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 25MA08394000 NJ
Obstetrics & Gynecology Physician 207V00000X ME105721 FL
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X ME105721 FL Primary

Addresses

Primary practice location

9580 N US Highway 301
Wildwood, FL 34785-8772

Mailing address

9580 N US Highway 301
Wildwood, FL 34785-8772
Phone (352) 633-0703

Other identifiers 1

IdentifierTypeStateIssuer
002182700MedicaidFL

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
I20101004001279 FL Practitioner - Obstetrics/GynecologyPractitioner - Urology 6204028632 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/GynecologyAlso: Urology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McRichlands PLLCGroup PAC ID 7012179914, 2 clinicians

Practice addresses (Care Compare)

9580 N US Hwy 301
Wildwood, FL 34785-8772
Phone (352) 633-0703

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08394000NJMDObstetrics & Gynecology Physician
ME105721FLMDFemale Pelvic Medicine and Reconstructive Surgery (Obstetrics & Gynecology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McRichlands PLLC Urogynecology and Reconstructive Pelvic Surgery CurrentSince Jan 9, 2012 Accepting new patients
Bellefull LLC Urogynecology and Reconstructive Pelvic Surgery CurrentSince Jun 19, 2020 Accepting new patients
Village Gynecology MD PA Past Accepting new patients
University Medical Service Association Inc Past Accepting new patients

Locations

1050 Old Camp Rd
Ste 206
The Villages, FL 32162
Phone (352) 353-0092

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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 1

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": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592524800000",
    "number": "1679734453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9580 N US HIGHWAY 301",
            "city": "WILDWOOD",
            "state": "FL",
            "postal_code": "347858772",
            "telephone_number": "352-633-0703",
            "fax_number": "352-399-2168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9580 N US HIGHWAY 301",
            "city": "WILDWOOD",
            "state": "FL",
            "postal_code": "347858772",
            "telephone_number": "352-633-0703",
            "fax_number": "352-399-2168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWAUBANI",
        "first_name": "UZOMA",
        "middle_name": "KELECHI",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-24",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MA08394000",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME105721",
            "primary": false
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "FL",
            "license": "ME105721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002182700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wildwood, FL

Sources for this page

Verify at the official NPI Registry.