Ibeawuchi Mbanu, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

036141515 Issued in IL

Practice address

6345 W 79TH St
Burbank, IL 60459-1133

Phone

(312) 609-0300

NPI assigned

Jan 10, 2007

Last updated

Jul 12, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in VA, TN2 enrollments

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 2

Specialty

Internal Medicine

Education

Wayne State University School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anova Medical Associates, PLCGroup PAC ID 8325372741, 130 clinicians

Hospital Medicine Services of TN LLCGroup PAC ID 2365807633, 266 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tristar Centennial Medical Center Hospital, Nashville, TN, CCN 440161
• Vanderbilt Bedford Hospital Hospital, Shelbyville, TN, CCN 440137

Merit-based Incentive Payment System (MIPS)

Final score

52.58 of 100Reported as group

Quality

13.74

Promoting interoperability

100

Improvement activities

0

Cost

74.27

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD
• Direct secure messaging: imbanu961311@direct.vumc.org

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.

• Anova Medical Associates, PLC

  • Hospitalist Physician
  • Gallatin, TN
  • NPI 1659849537
  Medicare reassignment Care Compare group NPD
• Hospital Medicine Services of TN, LLC

  • Hospitalist Physician
  • Nashville, TN
  • NPI 1982301065
  Medicare reassignment Care Compare group NPD
• Lake Spring Physician Services, LLC

  • Hospitalist Physician
  • Salem, VA
  • NPI 1568954287
  Medicare reassignment NPD
• Bon Secours-St. Mary's Hospital of Richmond, Inc.

  dba Bon Secours Infectious Disease Specialists

  • Infectious Disease Physician
  • Richmond, VA
  • NPI 1063772143
  NPD (past)
• Bon Secours-St. Mary's Hospital of Richmond, Inc.

  dba Bon Secours Sports Medicine & Primary Care

  • Sports Medicine (Internal Medicine) Physician
  • Richmond, VA
  • NPI 1255776290
  NPD (past)
• Bon Secours-St. Mary's Hospital of Richmond, Inc.

  • Family Medicine Physician
  • Richmond, VA
  • NPI 1942598693
  NPD (past)
• Inpatient Medical Services, P.a.

  dba Intercede Health

  • Internal Medicine Physician
  • Pasadena, TX
  • NPI 1104868975
  NPD (past)
• Inpatient Specialists PA

  • Internal Medicine Physician
  • Rockville, MD
  • NPI 1700858586
  NPD (past)
• Tidewater Physicians Multispecialty Group PC

  • Ambulatory Surgical Clinic/Center
  • Williamsburg, VA
  • NPI 1316790512
  NPD (past)

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

• HCA Health Services of Tennessee, Inc.

  dba Tristar Centennial Medical Center

  • General Acute Care Hospital
  • Nashville, TN
  • NPI 1023055126
  Care Compare affiliation
• Vanderbilt Bedford Hospital, LLC

  dba Vanderbilt Bedford Hospital

  • General Acute Care Hospital
  • Shelbyville, TN
  • NPI 1487253449
  Care Compare affiliation

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1851441349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6345 W 79TH ST",
            "city": "BURBANK",
            "state": "IL",
            "postal_code": "604591133",
            "telephone_number": "312-609-0300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5801 Bremo Rd",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232261907",
            "country_code": "US",
            "telephone_number": "804-287-7270",
            "fax_number": "804-285-0726",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4201 W Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "McHenry",
            "state": "IL",
            "postal_code": "600508409",
            "country_code": "US",
            "telephone_number": "815-759-4323",
            "fax_number": "815-759-4948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MBANU",
        "first_name": "IBEAWUCHI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101239124",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0101239124",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036141515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C06778",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "imbanu278280@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "6345 W 79th St",
            "city": "Burbank",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604591133",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "6345 W 79th St",
            "city": "Burbank",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604591133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christina Marchione, O.D.
• Joseline Marquez, BCBA
• Hema Mathur, MD
• Virendra Mathur, MD
• Megan Matura
• Katija McCarthy, N.P.
• Martha M McInerney, LCSW
• William J. McNichols, LPC
• Maureen E McQuaid, MS
• Med First Imaging Inc

• Hospitalist Physician in Burbank, IL
• Providers in Burbank, IL by specialty
• Hospitalist Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.