Individual provider Active NPI

De Gaulle I Chigbu, OD

  • Optometrist
  • Philadelphia, PA
National Provider Identifier
1730197518
Registry record updated Feb 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG001442 Issued in PA
Practice address
1200 W Godfrey Ave
Philadelphia, PA 19141-3323
Phone
(215) 276-6000
NPI assigned
Aug 4, 2006
Last updated
Feb 15, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG001442 PA Primary

Addresses

Primary practice location

1200 W Godfrey Ave
Philadelphia, PA 19141-3323

Mailing address

7602 Massey Way # B
Elkins Park, PA 19027-1010
Phone (215) 887-0946

Other identifiers 2

IdentifierTypeStateIssuer
1640750OtherPABLUE SHIELD
101108790001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040830000031 PA Practitioner - Optometry 6507831021 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Drexel UniversityGroup PAC ID 5496664740, 80 clinicians

Practice addresses (Care Compare)

1200 W Godfrey Ave
Philadelphia, PA 19141-3323
Phone (215) 276-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Drexel University CurrentSince Dec 23, 2024 Accepting new patients
Salus University Hearing Vision Balance Clinic Optometrist CurrentSince Jul 1, 2004 Accepting new patients
Drexel University Optometrist CurrentSince Jul 1, 2004 Accepting new patients
Drexel University CurrentSince Dec 23, 2024 Accepting new patients
Drexel University Current Accepting new patients

Locations

1200 W Godfrey Ave
Philadelphia, PA 19141
Phone (215) 276-6000

1427 Vine St
Fl 2
Philadelphia, PA 19102
Phone (215) 762-2530

1427 Vine St
Fl 8
Philadelphia, PA 19102
Phone (215) 762-6660

7630 Germantown Ave
Ste 4
Philadelphia, PA 19118
Phone (215) 276-6000

Interoperability endpoints

  • Direct secure messaging: degaulle.chigbu.p1@direct.salusuhealth.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1730197518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7602 MASSEY WAY # B",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190271010",
            "telephone_number": "215-887-0946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W GODFREY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413323",
            "telephone_number": "215-276-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIGBU",
        "first_name": "DE GAULLE",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "1640750",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101108790001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.