Innocent Chukwuma Ezenwa, MD

Primary specialty

Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X

License

16000 Issued in NV

Practice address

2115 Green Vista Dr Ste 101
Sparks, NV 89431-8516

Phone

(775) 557-4900

Fax

(775) 557-7240

NPI assigned

Mar 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

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

Specialty

Internal Medicine

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Meliorem Sleep ServicesGroup PAC ID 0143506576, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75.91 of 100Reported as individual

Quality

71.14

Promoting interoperability

100

Improvement activities

40

Cost

48.55

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: innocent.ezenwa.1@20290.direct.athenahealth.com

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.

• Meliorem Sleep Services

  • Sleep Disorder Diagnostic Clinic/Center
  • Sparks, NV
  • NPI 1619417136
  Medicare reassignment Care Compare group Authorized official
• William Bee Ririe Hospital

  • Critical Access Hospital
  • Ely, NV
  • NPI 1487648804
  Medicare reassignment NPD
• William Bee Ririe Retail Pharmacy

  • Community/Retail Pharmacy
  • Ely, NV
  • NPI 1831729268
  NPD
• PHC-Elko Inc

  • Rural Acute Care Hospital
  • Elko, NV
  • NPI 1770674350
  NPD (past)
• Copley Hospital, Inc.

  • Critical Access Hospital
  • Morrisville, VT
  • NPI 1568414365
  NPD (past)
• Northeastern Vermont Regional Hospital, Inc

  • Critical Access Hospital
  • St Johnsbury, VT
  • NPI 1861439275
  NPD (past)

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1699891192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 GREEN VISTA DR STE 101",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894318516",
            "telephone_number": "775-557-4900",
            "fax_number": "775-557-7240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 GREEN VISTA DR STE 101",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894318516",
            "telephone_number": "775-557-4900",
            "fax_number": "775-557-7240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZENWA",
        "first_name": "INNOCENT",
        "middle_name": "CHUKWUMA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "VT",
            "license": "042-0012250",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "NV",
            "license": "16000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wylie Evanson
• Robin Evensen
• Lisa Susan Everett-Bridgewater, PT
• Brandie Ann Ewing
• Eyetech Visioncare, LTD
• Roslynn Fabian
• Brittany Fader, SLP
• Faith & Hope Home Care LLC
• Marlena Katherine Fajardo, DTR
• Family Behavioral Health LLC

• Sleep Medicine (Internal Medicine) Physician in Sparks, NV
• Providers in Sparks, NV by specialty
• Sleep Medicine (Internal Medicine) Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.