NPIMap

Individual provider Active NPI

Ivy-Joan Erinma Madu, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Orange, CA
National Provider Identifier
1710988662
Registry record updated Apr 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
A50150 Issued in CA
Practice address
1310 W Stewart Dr Ste 610
Orange, CA 92868-3857
Phone
(714) 639-1815
Fax
(714) 639-2374
NPI assigned
Aug 2, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X A50150 CA Primary

Addresses

Primary practice location

1310 W Stewart Dr Ste 610
Orange, CA 92868-3857

Mailing address

PO Box 1693
Orange, CA 92856-0693
Phone (714) 639-1815

Other identifiers 2

IdentifierTypeStateIssuer
00A501500MedicaidCA
00A501500OtherCACALOPTIMA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address DiabetesMD@sbcglobal.net Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110202000551 CA Practitioner - Internal MedicinePractitioner - Endocrinology 0547440992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Endocrinology
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1310 W Stewart Dr
Suite 610
Orange, CA 92868-3857
Phone (714) 639-1815

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph Hospital Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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 4

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": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650067200000",
    "number": "1710988662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1693",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928560693",
            "telephone_number": "714-639-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 W STEWART DR STE 610",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683857",
            "telephone_number": "714-639-1815",
            "fax_number": "714-639-2374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADU",
        "first_name": "IVY-JOAN",
        "middle_name": "ERINMA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2022-04-16",
        "certification_date": "2022-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A50150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A501500",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALOPTIMA",
            "identifier": "00A501500",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "DiabetesMD@sbcglobal.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "DiabetesMD@sbcglobal.net",
            "address_1": "1310 W Stewart Dr Ste 610",
            "city": "Orange",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928683857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.