Individual provider Active NPI

Chinenye U Eze-Raphael, MD

  • Internal Medicine Physician
  • Bloomington, IN
National Provider Identifier
1992352934
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01087442A Issued in IN
Practice address
2651 E Discovery Pkwy
Bloomington, IN 47408-9059
Phone
(812) 676-4102
Fax
(812) 676-4106
NPI assigned
Aug 23, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 01087442A IN Primary

Addresses

Primary practice location

2651 E Discovery Pkwy
Bloomington, IN 47408-9059

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

Maimonides Medical Center
4802 10th Avenue
Brroklyn, NY 11219
Phone (718) 383-6000

Other names 1

  • Chinenye U Oguejiofor Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cezeraphael@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20220613001339 IN Practitioner - Internal Medicine 2769814474 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

2651 E Discovery Pkwy
Bloomington, IN 47408-9059
Phone (812) 353-9250

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
63.48 of 100Reported as individual
Quality
15.41
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01087442AINMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Southern Indiana Physicians, LLC Internal Medicine CurrentSince Aug 1, 2022 Accepting new patients
Indiana University Health Southern Indiana Physicians LLC CurrentSince Aug 1, 2022 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Jan 1, 2026 Accepting new patients

Locations

727 W 2nd St
Bloomington, IN 47403
Phone (812) 353-3450

2651 E Discovery Pkwy
Bloomington, IN 47408
Phone (812) 353-9147

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

Interoperability endpoints

  • Direct secure messaging: cezeraphael@direct.iuhealth.org

Organizations & group practices 3

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 5

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": "1566518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1992352934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2651 E DISCOVERY PKWY",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474089059",
            "telephone_number": "812-676-4102",
            "fax_number": "812-676-4106"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Maimonides Medical Center",
            "address_2": "4802 10th Avenue",
            "address_purpose": "LOCATION",
            "city": "Brroklyn",
            "state": "NY",
            "postal_code": "11219",
            "country_code": "US",
            "telephone_number": "718-383-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EZE-RAPHAEL",
        "first_name": "CHINENYE",
        "middle_name": "U",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-23",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01087442A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cezeraphael@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2651 E Discovery Pkwy",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474089059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHINENYE",
            "last_name": "OGUEJIOFOR",
            "middle_name": "U",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.