NPIMap

Individual provider Active NPI

Promise Ojukwu, M.D

  • Gynecology Physician
  • Las Vegas, NV
National Provider Identifier
1790087732
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
17523 Issued in NV
Practice address
5320 S Rainbow Blvd Ste 182
Las Vegas, NV 89118-1896
Phone
(702) 255-3547
Fax
(702) 212-4993
NPI assigned
Nov 24, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X 036136819 IL
Gynecology Physician 207VG0400X 17523 NV Primary

Addresses

Primary practice location

5320 S Rainbow Blvd Ste 182
Las Vegas, NV 89118-1896

Mailing address

6355 S Buffalo Dr FL 3
Las Vegas, NV 89113-2133
Phone (702) 216-3346

Other identifiers 2

IdentifierTypeStateIssuer
CF3444OtherILMEDICARE RR
036136819MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20180108002848 NV Practitioner - Obstetrics/Gynecology 0547586968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intermountain Medical Holdings Nevada IncGroup PAC ID 7416054622, 311 clinicians

Practice addresses (Care Compare)

5320 S Rainbow Blvd
Suite 182
Las Vegas, NV 89118-1896
Phone (702) 304-5827

Hospital & facility affiliations

  • Spring Valley Hospital Medical Center Hospital, Las Vegas, NV, CCN 290046

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036136819ILMDObstetrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Holdings Nevada Inc CurrentSince Jan 4, 2022 Accepting new patients
Healthcare Partners Medical Group Coats LTD Current Accepting new patients
Intermountain Medical Holdings Nevada Inc Obstetrics & Gynecology CurrentSince Jan 4, 2022 Accepting new patients
Southern Hills Medical Center, LLC Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Shawnee Health Service and Development Corp Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Spring Valley Medical Center Past Accepting new patients
Shawnee Health Service and Development Corp Past Accepting new patients
Mountain View Hospital LLC Past Accepting new patients
Spring Valley Medical Center Past Accepting new patients
Healthcare Partners Medical Group (Coats) LTD. Past Accepting new patients
Shawnee Health Service and Development Corp Obstetrics Past Accepting new patients
Summerlin Hospital Medical Center L L C Past Accepting new patients

Locations

595 W Lake Mead Pkwy
Henderson, NV 89015
Phone (702) 566-5500

6355 S Buffalo Dr
Fl 3
Las Vegas, NV 89113
Phone (702) 479-4881

5320 S Rainbow Blvd
Ste 182
Las Vegas, NV 89118
Phone (702) 304-5722

4880 Wynn Rd
Las Vegas, NV 89103
Phone (702) 382-4554

1397 S Loop Rd
Pahrump, NV 89048
Phone (775) 727-5500

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 3

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": "1290556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1790087732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6355 S BUFFALO DR FL 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891132133",
            "telephone_number": "702-216-3346",
            "fax_number": "702-671-6883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5320 S RAINBOW BLVD STE 182",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891181896",
            "telephone_number": "702-255-3547",
            "fax_number": "702-212-4993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OJUKWU",
        "first_name": "PROMISE",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-24",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "IL",
            "license": "036136819",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NV",
            "license": "17523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "CF3444",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036136819",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.