Herbert Osita Ezugha, M.D.

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

ME127563 Issued in FL

Practice address

2500 Wigwam Pkwy Ste 111
Henderson, NV 89074-7113

Phone

(702) 852-1155

Fax

(702) 246-0195

NPI assigned

Jul 22, 2008

Last updated

Jan 24, 2020By the provider in NPPES

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

Other names 1

• Dr. Herbert Osita Ezugha Other name

Medicare fee-for-service enrollment

Enrolled in NV, CO2 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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Obstetrix Medical Group of Colorado P C

  dba Pediatrix Obstetrix Medical Group of Colorado

  • Neonatal-Perinatal Medicine Physician
  • Denver, CO
  • NPI 1700983103
  Medicare reassignment
• Ezugha Pediatric Neurology and Associates PC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Henderson, NV
  • NPI 1184270258
  Authorized official Same address or phone
• Obstetrix Medical Group of Colorado P C

  dba Rocky Mountain Pediatric Cardiology

  • Pediatric Cardiology Physician
  • Denver, CO
  • NPI 1497779276
  NPD
• Dignity Health

  dba St. Rose Dominican Hospital, Siena Campus

  • General Acute Care Hospital
  • Henderson, NV
  • NPI 1770626426
  NPD (past)
• HCA Healthone LLC

  dba HCA HealthONE Presbyterian St. Lukes Hospital

  • General Acute Care Hospital
  • Denver, CO
  • NPI 1720038946
  NPD (past)

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

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1871758649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 WIGWAM PKWY STE 111",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747113",
            "telephone_number": "702-852-1155",
            "fax_number": "702-246-0195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 WIGWAM PKWY STE 111",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747113",
            "telephone_number": "702-852-1155",
            "fax_number": "702-246-0195"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "331 N Maitland Ave Ste D3",
            "address_purpose": "LOCATION",
            "city": "Maitland",
            "state": "FL",
            "postal_code": "327514755",
            "country_code": "US",
            "telephone_number": "407-775-5035",
            "fax_number": "407-255-8823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EZUGHA",
        "first_name": "HERBERT",
        "middle_name": "OSITA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-22",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "FL",
            "license": "ME127563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HERBERT",
            "last_name": "EZUGHA",
            "middle_name": "OSITA",
            "prefix": "DR.",
            "credential": "N/A",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Eye Options Inc. (Eye Options)
• Eye Site (The Eyesite of Anthem)
• Leslie Joy Ezpeleta
• Ezugha Pediatric Neurology and Associates PC
• Amara Ezugha
• F and G ABA
• Itzel Fabian-Palafox
• Wildaline Fabian
• Fabito Anesthesia & Pain Specialists PC
• Daniel E Fabito, M.D.

• Neurology with Special Qualifications in Child Neurology Physician in Henderson, NV
• Providers in Henderson, NV by specialty
• Neurology with Special Qualifications in Child Neurology Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.