Individual provider Active NPI

Enobong Efiong, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Washington, DC
National Provider Identifier
1912341462
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
MD046532 Issued in DC
Practice address
110 Irving St NW
Washington, DC 20010-3017
Phone
(202) 877-7259
NPI assigned
Apr 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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 MD046532 DC
Critical Care Medicine (Internal Medicine) Physician 207RC0200X MD046532 DC Primary

Addresses

Primary practice location

110 Irving St NW
Washington, DC 20010-3017

Mailing address

105 Elizabeth Blackwell St # 621B
Syracuse, NY 13210-2304
Phone (917) 282-7196

Other practice location 1

Geisinger Medical Ctr
100 North Academy Avenue
Danville, PA 17822-0001
Phone (570) 271-6211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20211008002229 MA Practitioner - General Surgery 0749584738 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
State University of New York at Stony Brook, School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Medical AssociatesGroup PAC ID 7113029257, 443 clinicians

Practice addresses (Care Compare)

55 Fogg Rd
Weymouth, MA 02190-2432
Phone (781) 792-4136

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD046532DCMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham and Women's Hospital Current Accepting new patients
Coastal Medical Associates CurrentSince Aug 24, 2021 Accepting new patients
Brigham & Womens Physicians Organization Inc CurrentSince Sep 1, 2021 Accepting new patients
South Shore Hospital Inc. Past Accepting new patients

Locations

75 Francis St
Boston, MA 02115

1153 Centre St
#L1
Jamaica Plain, MA 02130

254 2nd Ave
Ste 100
Needham Heights, MA 02494
Phone (781) 416-8412

55 Fogg Rd
Weymouth, MA 02190
Phone (781) 340-4293

55 Fogg Rd
#81
Weymouth, MA 02190

Interoperability endpoints

  • Direct secure messaging: efiong.enobong.bwh@direct.partners.masshiway.net

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1366848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1912341462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 ELIZABETH BLACKWELL ST # 621B",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102304",
            "telephone_number": "917-282-7196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 IRVING ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200103017",
            "telephone_number": "202-877-7259"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Geisinger Medical Ctr",
            "address_2": "100 North Academy Avenue",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "PA",
            "postal_code": "178220001",
            "country_code": "US",
            "telephone_number": "570-271-6211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EFIONG",
        "first_name": "ENOBONG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-25",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "DC",
            "license": "MD046532",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "DC",
            "license": "MD046532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.