Individual provider Active NPI

Ifeyinwa Mary Asuzu, MD

  • Student in an Organized Health Care Education/Training Program
  • New York, NY
National Provider Identifier
1922593813
Registry record updated Feb 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1 Edgewater Plaza Staten Island
New York, NY 10305
Phone
(718) 226-1019
NPI assigned
Jun 25, 2018
Reactivated
Feb 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1 Edgewater Plaza Staten Island
New York, NY 10305

Mailing address

475 Seaview Avenue Staten Island
New York, NY 10305
Phone (718) 226-8855

Other names 1

  • Miss Ifeyinwa Mary Onwubuya Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20240702000373 NY Practitioner - Pathology 2668714346 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathology Consultants of Brooklyn 10 clinicians

Practice addresses (Care Compare)

4802 10TH Ave
Brooklyn, NY 11219-2916
Phone (718) 283-7010

Hospital & facility affiliations

  • Maimonides Medical Center Hospital, Brooklyn, NY, CCN 330194
  • New York Community Hospital of Brooklyn, Inc. Hospital, Brooklyn, NY, CCN 330019

National Provider Directory

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

Practice roles (2 of 6)

OrganizationSpecialtyStatusNew patients
Pathology Consultants of Brooklyn CurrentSince Aug 1, 2024 Accepting new patients
Maimonides Faculty Practice Plan CurrentSince Aug 1, 2024 Accepting new patients

Locations

4508 16th Ave
Brooklyn, NY 11204
Phone (718) 972-8018

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

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.

Hospital & facility affiliations 2

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": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550534400000",
    "number": "1922593813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVENUE STATEN ISLAND",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10305",
            "telephone_number": "718-226-8855",
            "fax_number": "718-226-1347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EDGEWATER PLAZA STATEN ISLAND",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10305",
            "telephone_number": "718-226-1019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASUZU",
        "first_name": "IFEYINWA",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-25",
        "last_updated": "2019-02-19",
        "deactivation_date": "2019-02-13",
        "reactivation_date": "2019-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IFEYINWA",
            "last_name": "ONWUBUYA",
            "middle_name": "MARY",
            "prefix": "MISS",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.