Ifeoma Ezeh Omoregie, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

7186 Issued in GA

Practice address

1404 River PL Ste 501
Braselton, GA 30517-5600

Phone

(770) 534-2020

Fax

(770) 534-8025

NPI assigned

Aug 4, 2014

Last updated

Dec 8, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northside Cardiovascular Professional Services, LLCGroup PAC ID 9739189838, 143 clinicians

The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Emory University Hospital Hospital, Atlanta, GA, CCN 110010

Merit-based Incentive Payment System (MIPS)

Final score

76.66 of 100Reported as group

Quality

58.46

Promoting interoperability

83

Improvement activities

40

Cost

77.92

Merit-based Incentive Payment System (MIPS)

Final score

94.51 of 100Reported as apm

Quality

80.61

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

77.82 of 100Reported as group

Quality

67.82

Promoting interoperability

77

Improvement activities

40

Cost

77.43

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: iezehomoregie104072@nghs.gadirect.net

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.

• The Emory Clinic Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1396798229
  Medicare reassignment Care Compare group NPD
• Northside Cardiovascular Professional Services, LLC

  • Cardiovascular Disease Physician
  • Roswell, GA
  • NPI 1518979921
  Medicare reassignment Care Compare group
• Georgia Heart Institute LLC

  • Cardiovascular Disease Physician
  • Gainesville, GA
  • NPI 1477976520
  Medicare reassignment
• Gwinnett Physician Group, LLC

  • Internal Medicine Physician
  • Lawrenceville, GA
  • NPI 1578574661
  Medicare reassignment
• Northeast Georgia Heart Center

  • Cardiovascular Disease Physician
  • Gainesville, GA
  • NPI 1508812421
  NPD
• Gwinnett Medical Group, Inc

  • General Practice Physician
  • Lawrenceville, GA
  • NPI 1780747469
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Emory University

  dba Emory University Hospital

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1588640692
  Care Compare affiliation
• Emory University

  dba Emory University Hospital At Wesley Woods

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1770560294
  Care Compare affiliation

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

{
    "created_epoch": "1407110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1710396734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 RIVER PL STE 501",
            "city": "BRASELTON",
            "state": "GA",
            "postal_code": "305175600",
            "telephone_number": "770-534-2020",
            "fax_number": "770-534-8025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZEH OMOREGIE",
        "first_name": "IFEOMA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-04",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "7186",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "7186",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "iezehomoregie104072@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1404 River Pl Ste 501",
            "city": "Braselton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305175600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amberly Ellis, LPC
• Shannon M Ellis, PTA
• Elizabeth Smith Elmadolar, FNP-BC
• Kayla W Emmett, PT, DPT
• Gemma P English, DPM
• Erum Farooqi, M.D.
• Carla Louise Fedigan, RN, MSN, WHNP-BC
• Lucy Anne Fischer
• Shameka Flanagan
• Laura Flick

• Medical Physician Assistant in Braselton, GA
• Providers in Braselton, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; 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.