Kelechi Ego-Osuala

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

D0095010 Issued in MD

Practice address

5305 Kenilworth Ave
Riverdale, MD 20737-3101

Phone

(301) 277-7110

NPI assigned

May 18, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

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

Specialty

Family PracticeAlso: General Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Edge Family Medicine LLC

  • Family Medicine Physician
  • Riverdale, MD
  • NPI 1801517453

  DC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1558137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662163200000",
    "number": "1841856499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5305 KENILWORTH AVE",
            "city": "RIVERDALE",
            "state": "MD",
            "postal_code": "207373101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5305 KENILWORTH AVE",
            "city": "RIVERDALE",
            "state": "MD",
            "postal_code": "207373101",
            "telephone_number": "301-277-7110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 W 5th St",
            "address_purpose": "LOCATION",
            "city": "Odessa",
            "state": "TX",
            "postal_code": "797634206",
            "country_code": "US",
            "telephone_number": "432-703-5238",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EGO-OSUALA",
        "first_name": "KELECHI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-18",
        "last_updated": "2022-09-03",
        "certification_date": "2022-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0095010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edge Medical Care PC
• Vernicia A Edmond, CRNP
• Eduardo Armenta MD
• Eduardo Armenta, M.D.
• Grace Oluwatoyin Efunbajo, DNP-FNP
• Beverely Chiazo Ejimakor
• Chelsea A. Ejimakor
• Eko Elad
• Diana Elias Gonzalez
• Amina Elmi, OTR/L

• Family Medicine Physician in Riverdale, MD
• Providers in Riverdale, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.