Individual provider Active NPI

Obinna Uchenna Nwobi, MD

  • Vascular Surgery Physician
  • Winter Haven, FL
National Provider Identifier
1912028853
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
ME106633 Issued in FL
Practice address
1121 1St St S
Winter Haven, FL 33880-3902
Phone
(877) 817-8346
Fax
(321) 286-0517
NPI assigned
Apr 2, 2007
Last updated
Jul 13, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 25MA08134900 NJ
Vascular Surgery Physician 2086S0129X ME106633 FL Primary

Addresses

Primary practice location

1121 1St St S
Winter Haven, FL 33880-3902

Mailing address

1121 1St St S
Winter Haven, FL 33880-3902
Phone (877) 817-8346

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100719000870 FL Practitioner - Vascular SurgeryPractitioner - Interventional Radiology 2769573351 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
University of Tennessee, HSC, College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1121 1St St S
Winter Haven, FL 33880-3902
Phone (877) 817-8346

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal113
Leg revascularization (restoring blood flow)13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME106633FLMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Keyhole Surgery Center-Winter Haven LLC Current Accepting new patients
Vascular Health Institute Inc Vascular Surgery CurrentSince Jan 15, 2017 Accepting new patients
Vascular & Endovascular Surgical Consultants of Orlando PA Vascular Surgery PastSince Oct 1, 2004 Accepting new patients
Vascular Health Institute Inc Vascular Surgery Past Accepting new patients
Vascular Health Institute Inc Vascular Surgery Past Accepting new patients
Vascular Health Institute Inc Vascular Surgery Past Accepting new patients
DHHS, PHS, Naihs, Gallup Indian Medical Center Past Accepting new patients

Locations

572 Ocoee Commerce Pkwy
Ocoee, FL 34761
Phone (407) 228-6635

1000 Executive Dr
Ste 8
Oviedo, FL 32765
Phone (407) 977-9990

1410 W Broadway St
Ste 105
Oviedo, FL 32765
Phone (321) 304-6249

1801 SE Hillmoor Dr
Ste C-208
Port St Lucie, FL 34952
Phone (772) 261-5116

1121 1st St S
Winter Haven, FL 33880
Phone (863) 293-2924

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1912028853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 1ST ST S",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338803902",
            "telephone_number": "877-817-8346",
            "fax_number": "321-286-0517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 1ST ST S",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338803902",
            "telephone_number": "877-817-8346",
            "fax_number": "321-286-0517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWOBI",
        "first_name": "OBINNA",
        "middle_name": "UCHENNA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA08134900",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "ME106633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

Verify at the official NPI Registry.