Chidimma I Okoli, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

253584 Issued in MA

Practice address

100 Grove St Ste 210
Worcester, MA 01605

Phone

(508) 556-1072

NPI assigned

Jun 3, 2010

Last updated

Dec 2, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cokoli23440@umassmemorial.direct-ci.com

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• CHS of Worcester, Inc

  dba St. Mary Health Care Center

  • Skilled Nursing Facility
  • Worcester, MA
  • NPI 1366500498

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

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.

• Worcester Physicians and Nurses Services LLC

  • Internal Medicine Physician
  • Worcester, MA
  • NPI 1164993291
  Medicare reassignment NPD
• Unbounded, LLC

  • Clinical Social Worker
  • Worcester, MA
  • NPI 1295459261
  NPD
• Christopher House, Inc

  • Skilled Nursing Facility
  • Worcester, MA
  • NPI 1669472494
  NPD (past)
• CHS of Worcester, Inc

  dba St. Mary Health Care Center

  • Skilled Nursing Facility
  • Worcester, MA
  • NPI 1366500498
  NPD (past)
• Mikhail Novikov MD

  • Surgery Physician
  • Attleboro, MA
  • NPI 1467793380
  NPD (past)

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

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1972823870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GROVE ST STE 210",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052627",
            "telephone_number": "508-556-1072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GROVE ST STE 210",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01605",
            "telephone_number": "508-556-1072"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "367 Plantation St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016052323",
            "country_code": "US",
            "telephone_number": "508-334-1443",
            "fax_number": "508-334-1448",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OKOLI",
        "first_name": "CHIDIMMA",
        "middle_name": "I",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-03",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "253584",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MA",
            "license": "253584",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110100196A",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cokoli23440@UmassMemorial.direct-ci.com",
            "affiliation": "N",
            "address_1": "367 Plantation St",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016052323",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "367 Plantation St",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016052323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Emike Okhipo, MD
• Elizabeth Okhrimenko
• Eromosele Steven Okhuebor, PA
• Okike Nsidinanya Okike, M.D.
• Emmanuella Okla
• Rosamystica Nyamombi Okumu
• Temitayo Olasehinde
• Joseph Olawale Olatunji, DPM
• Katiemae Sky Olderstein
• Kaitlyn Oldewurtel, DO

• Internal Medicine Physician in Worcester, MA
• Providers in Worcester, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.