Uchenna Cletus Acholonu Jr., M.D.
Individual provider Active NPI Obstetrics & Gynecology Physician · New York, NY
NPI 1679764823 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1679764823
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 245177 (NY)
- Practice address
- 1090 Amsterdam Ave
Suite 3a
New York, NY 10025-1737 - Phone
- (212) 636-1130
- Fax
- (212) 636-1133
- NPI assigned
- Aug 5, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Obstetrics/Gynecology
- Education
- State University of Ny Upstate Medical University, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- North Shore-Lij Medical PC
Practice addresses (Care Compare)
1554 Northern Blvd
Manhasset, NY 11030-3006
Phone (516) 390-9242
Hospital & facility affiliations
- Long Island Jewish Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.07 of 100
- Quality
- 79.77
- Promoting interoperability
- 88.77
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080402000301 | NY | Practitioner - Obstetrics/Gynecology | 3173600152 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles (4 of 8)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Weill Medical College of Cornell | Current |
Accepting new patients | |
| North Shore-Lij Medical PC | Obstetrics & Gynecology | Current |
Accepting new patients |
| Weill Medical College of Cornell | Obstetrics & Gynecology | Current |
Accepting new patients |
| Long Island Jewish Medical Center | Past | Accepting new patients |
Locations
10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091
1554 Northern Blvd
Manhasset, NY 11030
Phone (516) 390-9242
525 E 68th St
#J130
New York, NY 10065
Phone (212) 746-3000
1111 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2309
1000 10th Ave
New York, NY 10019
Phone (212) 523-2369
300 Community Dr
Plandome, NY 11030
972 Brush Hollow Rd
Westbury, NY 11590
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
Interoperability endpoints
- uchennaacholonu@nslijmedgr.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 245177 | NY | Yes |
Addresses
Primary practice location
1090 Amsterdam Ave
Suite 3a
New York, NY 10025-1737
Mailing address
PO Box 95000-2243
Philadelphia, PA 19195-2243
Phone (516) 338-5300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02925006 | Medicaid | NY | |
| 245177-1 | Other | NY | NYS LICENSE |
Other providers in New York, NY
- Achilles Medical P.C.
- Lesley Achitoff
- Emil Achmad
- Nonyerem Okwukwe Acholonu-Fomin
- Rhonda Graves Acholonu
- Wies Achterkamp-Hurkmans
- Evelyn E Achugonye
- Mary Ann Domingo Acierto
- Ceren Acik
- Lauren Acinapura
All providers in New York, NY · Obstetrics & Gynecology Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.