Iheanyichukwu Aja-Onu, M.D.

Individual provider Active NPI Gastroenterology Physician · Freeport, NY

NPI 1720077944 · NPPES record last updated Jan 5, 2021

Key facts

NPI
1720077944
Entity type
Individual (NPI type 1)
Primary specialty
Gastroenterology Physician 207RG0100X
License
203413 (NY)
Practice address
3 N Main St
Freeport, NY 11520-2218
Phone
(516) 623-5076
Fax
(516) 623-5076
NPI assigned
Oct 20, 2005
Sex
Male
Sole proprietor
No

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 5

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

Medicare Care Compare profile

Specialty
Gastroenterology
Also: Internal Medicine
Education
State University of New York Downstate Medical Center, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3 N Main St
Freeport, NY 11520-2218
Phone (516) 623-5076

327 Beach 19TH St
Far Rockaway, NY 11691-4423
Phone (516) 623-5076

Hospital & facility affiliations

  • Mercy Medical Center Hospital · Rockville Centre, NY · CCN 330259
  • St John'S Episcopal Hospital at South Shore Hospital · Far Rockaway, NY · CCN 330395
  • Mount Sinai South Nassau Hospital · Oceanside, NY · CCN 330198
  • Long Island Jewish Medical Center Hospital · New Hyde Park, NY · CCN 330195
  • Mercy Medical Center Inpatient rehabilitation facility · Rockville Centre, NY · CCN 33T259

Merit-based Incentive Payment System (MIPS)

Final score
95.29 of 100 (apm)
Quality
80.38
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy249
Upper gastrointestinal (GI) endoscopy for acid reflux442

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 IDStateProvider typePAC IDDetails
I20040907001363 NY Practitioner - Gastroenterology
Practitioner - Internal Medicine
5496721870 Practice locations: Far Rockaway, NY; Freeport, NY

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles (3 of 7)

OrganizationSpecialtyStatusNew patients
Main Street Kidney Group Current
since Apr 6, 2021
Accepting new patients
Main Street Dialysis Center LLC Current
since Jan 10, 2021
Accepting new patients
Peninsula Medical Services PC Past Accepting new patients

Locations

3 N Main St
Fl 2
Freeport, NY 11520
Phone (718) 464-6700

3 N Main St
Freeport, NY 11520
Phone (516) 623-5076

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DDHHBA/Endpoint/DDHHBA

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 203413 NY Yes

Addresses

Primary practice location

3 N Main St
Freeport, NY 11520-2218

Mailing address

PO Box 37216
Elmont, NY 11003-7216
Phone (516) 623-5076

Other identifiers

IdentifierTypeStateIssuer
01956665MedicaidNY

Other providers in Freeport, NY

All providers in Freeport, NY · Gastroenterology Physician in New York

Sources for this page

Verify at the official NPI Registry.