Individual provider Active NPI

Iheanyichukwu Aja-Onu, M.D.

  • Gastroenterology Physician
  • Freeport, NY
National Provider Identifier
1720077944
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
203413 Issued in NY
Practice address
3 N Main St
Freeport, NY 11520-2218
Phone
(516) 623-5076
Fax
(516) 623-5076
NPI assigned
Oct 20, 2005
Last updated
Jan 5, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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

Specialties & licenses 1

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

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040907001363 NY Practitioner - GastroenterologyPractitioner - Internal Medicine 5496721870 Practice locations: Far Rockaway, NY; Freeport, NY

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: 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

Merit-based Incentive Payment System (MIPS)

Final score
95.29 of 100Reported as apm
Quality
80.38
Improvement activities
40

Procedures performed for Medicare patients

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

National Provider Directory

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

Practice roles

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

Locations

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

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

Networks

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

Interoperability endpoints

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1720077944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37216",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110037216",
            "telephone_number": "516-623-5076",
            "fax_number": "516-623-0312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 N MAIN ST",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115202218",
            "telephone_number": "516-623-5076",
            "fax_number": "516-623-5076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJA-ONU",
        "first_name": "IHEANYICHUKWU",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "203413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, NY

Sources for this page

Verify at the official NPI Registry.