Individual provider Active NPI

Chukwueloka Obionwu Jr., MD, CAQSM

  • Sports Medicine (Family Medicine) Physician
  • Medford, MA
National Provider Identifier
1679929715
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
283078 Issued in MA
Practice address
1 Cabot Rd FL 2
Medford, MA 02155-5117
Phone
(617) 665-1566
Fax
(617) 591-4690
NPI assigned
May 8, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 283078 MA Primary

Addresses

Primary practice location

1 Cabot Rd FL 2
Medford, MA 02155-5117

Mailing address

1 Cabot Rd FL 2
Medford, MA 02155-5117
Phone (617) 665-1566

Other practice location 1

77 Massachusetts Avenue
Building E23
Cambridge, MA 02139-4307
Phone (617) 253-4481

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20210211001093 MA Practitioner - Family PracticePractitioner - Sports Medicine 0547551434 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Tufts University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

103 Garland St
Everett, MA 02149-5066
Phone (617) 389-6270

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cambridge Public Health Commission CurrentSince Oct 3, 2025 Accepting new patients
Massachusetts Institute of Technology CurrentSince Nov 2, 2020 Accepting new patients
Cambridge Public Health Commission Current Accepting new patients

Locations

25 Carleton St
Cambridge, MA 02142
Phone (617) 253-0556

103 Garland St
Everett, MA 02149
Phone (617) 381-7150

195 Canal St
Malden, MA 02148
Phone (781) 338-0055

1 Cabot Rd
Medford, MA 02155
Phone (617) 591-6820

1 Cabot Rd
Fl 2
Medford, MA 02155
Phone (617) 591-6840

Interoperability endpoints

  • Direct secure messaging: cobionwu53201@direct.challiance.masshiway.net

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.

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": "1462665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1679929715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CABOT RD FL 2",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021555117",
            "telephone_number": "617-665-1566",
            "fax_number": "617-591-4690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CABOT RD FL 2",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021555117",
            "telephone_number": "617-665-1566",
            "fax_number": "617-591-4690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "77 Massachusetts Avenue",
            "address_2": "Building E23",
            "address_purpose": "LOCATION",
            "city": "Cambridge",
            "state": "MA",
            "postal_code": "021394307",
            "country_code": "US",
            "telephone_number": "617-253-4481",
            "fax_number": "617-258-0884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OBIONWU",
        "first_name": "CHUKWUELOKA",
        "name_suffix": "Jr.",
        "credential": "MD, CAQSM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-08",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MA",
            "license": "283078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

Verify at the official NPI Registry.