Maduka Harold Odogwu, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

33863 Issued in SC

Practice address

1010 N Belt Line Rd Ste 101
Mesquite, TX 75149-1770

Phone

(469) 862-3756

Fax

(469) 862-3766

NPI assigned

Aug 20, 2007

Reactivated

Sep 21, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Obstetrics/Gynecology

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Holy Cross OBGYNGroup PAC ID 7214291905, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epproxy.texashealth.org/FHIR/api/FHIR/DSTU2/

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.

• Holy Cross OBGYN

  • Obstetrics & Gynecology Physician
  • Mesquite, TX
  • NPI 1720581432

  Obstetrics & Gynecology, TX

  Medicare reassignment Care Compare group NPD Authorized official
• Lake Pointe Operating Company, LLC

  • General Acute Care Hospital
  • Rowlett, TX
  • NPI 1205018439
  NPD (past)
• Prime Healthcare Services Mesquite LLC

  • General Acute Care Hospital
  • Mesquite, TX
  • NPI 1790174860
  NPD (past)
• Rockwall Regional Hospital, LLC

  • General Acute Care Hospital
  • Rockwall, TX
  • NPI 1629138029
  NPD (past)
• Tyler Family Circle of Care

  • Community/Retail Pharmacy
  • Tyler, TX
  • NPI 1942011903
  NPD (past)
• St Francis Physician Services Inc

  • Family Medicine Physician
  • Greenville, SC
  • NPI 1295769438

  Obstetrics & Gynecology

  NPD (past)

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

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1861685372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 N BELT LINE RD STE 101",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751491770",
            "telephone_number": "469-862-3756",
            "fax_number": "469-862-3766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 N BELT LINE RD STE 101",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751491770",
            "telephone_number": "469-862-3756",
            "fax_number": "469-862-3766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Pelham Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296153300",
            "country_code": "US",
            "telephone_number": "864-234-5800",
            "fax_number": "864-284-0844",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 E High St Ste A",
            "address_purpose": "LOCATION",
            "city": "Terrell",
            "state": "TX",
            "postal_code": "751602660",
            "country_code": "US",
            "telephone_number": "972-210-7273",
            "fax_number": "469-862-3756",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4206 Dalrock Rd",
            "address_purpose": "LOCATION",
            "city": "Rowlett",
            "state": "TX",
            "postal_code": "750885546",
            "country_code": "US",
            "telephone_number": "469-862-3756",
            "fax_number": "469-862-3766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODOGWU",
        "first_name": "MADUKA",
        "middle_name": "HAROLD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-20",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "deactivation_date": "2022-08-30",
        "reactivation_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": "33863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "37996702",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "652387",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "33863",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "338637",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "Q8981",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "office@holycrossogyn.com",
            "affiliation": "N",
            "endpointDescription": "office email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1010 N Belt Line Rd Ste 101",
            "city": "Mesquite",
            "state": "TX",
            "country_code": "US",
            "postal_code": "751491770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Njideka Obi
• Oby'S Mobile Imaging
• Occupational Health Centers of the Southwest P.a.
• Occupational Health Centers of the Southwest, P.a.
• Teffany Odie, RN
• Abigail A Offringa
• Anthony Ikem Ogbolu, RPH
• Rachael O Ogunleye
• Meshach B Ogunmodede
• Dae Han Oh, DMD

• All providers in Mesquite, TX
• Obstetrics & Gynecology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.