Individual provider Active NPI

Leonard C. Egbujiobi, M.D.

  • Cardiovascular Disease Physician
  • Beloit, WI
National Provider Identifier
1972679355
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
30790-020 Issued in WI
Practice address
1969 West Hart Road
Beloit Memorial Hospital
Beloit, WI 53511
Phone
(608) 364-2200
Fax
(608) 363-7377
NPI assigned
Nov 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 30790-020 WI Primary

Addresses

Primary practice location

1969 West Hart Road
Beloit Memorial Hospital
Beloit, WI 53511

Mailing address

1905 E. Huebbe Parkway
Beloit Health System Inc
Beloit, WI 53511-1842
Phone (608) 364-2200

Other identifiers 2

IdentifierTypeStateIssuer
10798OtherDEAN HEALTH PLAN
1972679355MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20090120000688 WI Practitioner - Cardiovascular Disease (Cardiology) 2567525439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beloit Health System IncGroup PAC ID 8224947858, 138 clinicians

Practice addresses (Care Compare)

1650 Lee LN
Beloit, WI 53511-3935
Phone (608) 364-4670

1670 Lee LN
Beloit, WI 53511-3935
Phone (608) 364-5252

1735 Madison Rd
Beloit, WI 53511-3216
Phone (608) 363-7510

1905 E Huebbe Pkwy
Beloit, WI 53511-1842
Phone (608) 363-5000

1905 W Hart Rd
Beloit, WI 53511-2230
Phone (608) 364-2200

1969 W Hart Rd
Beloit, WI 53511-2230
Phone (608) 364-5756

2250 E W Hart Rd
Beloit, WI 53511-1816
Phone (608) 364-2200

307 Ogden Ave
Clinton, WI 53525-9007
Phone (608) 672-2206

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.93 of 100Reported as group
Quality
64.82
Promoting interoperability
100
Improvement activities
40
Cost
71.63

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting48
Pacemaker insertion or repair23
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30790-020WIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beloit Health System, Inc CurrentSince Jan 1, 2010 Accepting new patients
Beloit Health System Inc Cardiovascular Disease CurrentSince Jan 1, 2010 Accepting new patients
Beloit Clinic, S.C. Cardiovascular Disease Current Accepting new patients
Beloit Health System, Inc Past Accepting new patients

Locations

1735 Madison Rd
Beloit, WI 53511
Phone (608) 363-7510

1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011

1905 E Huebbe Pkwy
Beloit, WI 53511
Phone (608) 364-2293

307 Ogden Ave
Clinton, WI 53525
Phone (608) 364-1348

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 4

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318982400000",
    "number": "1972679355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 E. HUEBBE PARKWAY",
            "address_2": "BELOIT HEALTH SYSTEM INC",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535111842",
            "telephone_number": "608-364-2200",
            "fax_number": "608-363-7377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1969 WEST HART ROAD",
            "address_2": "BELOIT MEMORIAL HOSPITAL",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "53511",
            "telephone_number": "608-364-2200",
            "fax_number": "608-363-7377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGBUJIOBI",
        "first_name": "LEONARD",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2011-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "30790-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH PLAN",
            "identifier": "10798",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972679355",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beloit, WI

Sources for this page

Verify at the official NPI Registry.