Individual provider Active NPI

Ifeanyi Ezerendu Muoka, NP

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1871110387
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1000064 Issued in TX
Practice address
1778 Jerome Ave
Bronx, NY 10453-5708
Phone
(718) 583-3300
NPI assigned
Jun 30, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1000064 TX Primary

Addresses

Primary practice location

1778 Jerome Ave
Bronx, NY 10453-5708

Mailing address

1778 Jerome Ave
Bronx, NY 10453-5708
Phone (718) 583-3300

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220128000105 TX Practitioner - Nurse Practitioner 5597178319 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MD Hospitalists PLLCGroup PAC ID 7113209206, 21 clinicians

Practice addresses (Care Compare)

110 E Savannah Ave
BLDG B Suite 203
McAllen, TX 78503-1241
Phone (956) 686-7611

110 E Savannah Ave BLG B
Suite 202
McAllen, TX 78503-1241

Merit-based Incentive Payment System (MIPS)

Final score
99.92 of 100Reported as group
Quality
90.67
Improvement activities
40
Cost
78.84

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1000064TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brownsville Infectious Disease PA CurrentSince Mar 1, 2022 Accepting new patients

Locations

110 Uptown Ave
Ste B
Brownsville, TX 78520
Phone (956) 525-7817

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1871110387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1778 JEROME AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104535708",
            "telephone_number": "718-583-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1778 JEROME AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104535708",
            "telephone_number": "718-583-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUOKA",
        "first_name": "IFEANYI",
        "middle_name": "EZERENDU",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-30",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1000064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.