Individual provider Active NPI

Raphael Ezera Nwojo, M.D.

  • Otolaryngology Physician
  • Odessa, TX
National Provider Identifier
1891083689
Registry record updated Feb 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
Q6353 Issued in TX
Practice address
540 W 5TH St
Suite 410
Odessa, TX 79761-5034
Phone
(432) 333-8801
Fax
(432) 333-8136
NPI assigned
Jul 14, 2011
Last updated
Feb 3, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X TRN16148 FL
Otolaryngology Physician 207Y00000X Q6353 TX Primary

Addresses

Primary practice location

540 W 5TH St
Suite 410
Odessa, TX 79761-5034

Mailing address

PO Box 2129
Odessa, TX 79760-2129
Phone (432) 333-8808

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160929001882 TX Practitioner - Otolaryngology 6608163944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Texas Medical School at Houston, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Raphael E Nwojo MD PAGroup PAC ID 6305186412, 2 clinicians

Practice addresses (Care Compare)

225 N Lincoln Ave
Odessa, TX 79761-5032
Phone (432) 653-1484

540 W 5TH St
Suite 410
Odessa, TX 79761-5067
Phone (432) 653-1484

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.23 of 100Reported as group
Quality
62.45
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
TRN16148FLMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Raphael E Nwojo MD PA Otolaryngology CurrentSince Apr 1, 2019 Accepting new patients

Locations

225 N Lincoln Ave
Odessa, TX 79761
Phone (432) 580-0260

540 W 5th St
Ste 410
Odessa, TX 79761
Phone (432) 333-8808

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549152000000",
    "number": "1891083689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2129",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797602129",
            "telephone_number": "432-333-8808",
            "fax_number": "432-333-8136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 W 5TH ST",
            "address_2": "SUITE 410",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615034",
            "telephone_number": "432-333-8801",
            "fax_number": "432-333-8136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWOJO",
        "first_name": "RAPHAEL",
        "middle_name": "EZERA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-14",
        "last_updated": "2019-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "TRN16148",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "Q6353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.