Individual provider Active NPI

Chigozie Ebelenna Moronu, M.D

  • Hospitalist Physician
  • Jacksonville, FL
National Provider Identifier
1962740183
Registry record updated Jun 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
ME143340 Issued in FL
Practice address
820 Prudential Dr Ste 304
Jacksonville, FL 32207-8205
Phone
(904) 202-3860
Fax
(904) 202-3846
NPI assigned
Jan 23, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME143340 FL
Internal Medicine Physician 207R00000X 0101253722 VA
Hospitalist Physician 208M00000X 0101253722 VA
Hospitalist Physician 208M00000X ME143340 FL Primary

Addresses

Primary practice location

820 Prudential Dr Ste 304
Jacksonville, FL 32207-8205

Mailing address

PO Box 45443
Salt Lake City, UT 84145-0443
Phone (904) 202-1032

Other identifiers 1

IdentifierTypeStateIssuer
1962740183MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, FL2 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

Enrollment IDStateProvider typePAC IDDetails
I20190315002384 TX Practitioner - Internal Medicine 5496997645 Reassigns benefits to 1 organization
I20200602001487 FL Practitioner - HospitalistPractitioner - Internal Medicine 5496997645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Primary Care IncGroup PAC ID 0648177733, 459 clinicians

Practice addresses (Care Compare)

820 Prudential Dr
Suite 304
Jacksonville, FL 32207-8205
Phone (904) 202-3860

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.44 of 100Reported as apm
Quality
84.21
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101253722VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Primary Care Inc CurrentSince Jul 1, 2020 Accepting new patients
Lonestar Hospital Medicine Associates, PA Internal Medicine CurrentSince Apr 1, 2019 Accepting new patients
Baptist Primary Care Inc Internal Medicine Current Accepting new patients
Baptist Primary Care Inc. Internal Medicine CurrentSince Jul 1, 2020 Accepting new patients

Locations

820 Prudential Dr
Ste 304
Jacksonville, FL 32207
Phone (904) 202-3860

836 Prudential Dr
Ste 1207
Jacksonville, FL 32207
Phone (904) 396-8656

3500 W Wheatland Rd
Dallas, TX 75237
Phone (214) 947-5950

2700 E Broad St
Mansfield, TX 76063
Phone (682) 242-2000

Interoperability endpoints

  • Direct secure messaging: cmoronu28359@baptisthealthsystemjacksonville.direct-ci.com

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": "1358899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1962740183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 45443",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841450443",
            "telephone_number": "904-202-1032",
            "fax_number": "904-376-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 PRUDENTIAL DR STE 304",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078205",
            "telephone_number": "904-202-3860",
            "fax_number": "904-202-3846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORONU",
        "first_name": "CHIGOZIE",
        "middle_name": "EBELENNA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-23",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME143340",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101253722",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0101253722",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME143340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962740183",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.