Dr Kim Chiedozi Ohaegbulam, MD, PHD - Medicare Student in an Organized Health Care Education/Training Program in Forest Hills, NY

Dr Kim Chiedozi Ohaegbulam, MD, PHD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Forest Hills, New York. His current practice location is 102-01 66th Rd, Department Of Medicine, Forest Hills, New York. You can reach out to his office (for appointments etc.) via phone at (718) 830-4000.

Dr Kim Chiedozi Ohaegbulam is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1326508409.

Contact Information

Dr Kim Chiedozi Ohaegbulam, MD, PHD
102-01 66th Rd, Department Of Medicine,
Forest Hills, NY 11375
(718) 830-4000
Not Available



Physician's Profile

Full NameDr Kim Chiedozi Ohaegbulam
GenderMale
SpecialityStudent In An Organized Health Care Education/training Program
Location102-01 66th Rd, Forest Hills, New York
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1326508409
  • Provider Enumeration Date: 03/23/2019
  • Last Update Date: 12/29/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 0547684961
  • Enrollment ID: I20230131000165

Medical Identifiers

Medical identifiers for Dr Kim Chiedozi Ohaegbulam such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1326508409NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208D00000XGeneral Practice 0101277423 (Virginia)Secondary
390200000XStudent In An Organized Health Care Education/training Program (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Kim Chiedozi Ohaegbulam allows following entities to bill medicare on his behalf.
Entity NameSignify Health Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1689158487
PECOS PAC ID: 3274895263
Enrollment ID: O20210226002383

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kim Chiedozi Ohaegbulam is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Kim Chiedozi Ohaegbulam, MD, PHD
102-01 66th Rd, Department Of Medicine,
Forest Hills, NY 11375

Ph: (718) 830-4000
Dr Kim Chiedozi Ohaegbulam, MD, PHD
102-01 66th Rd, Department Of Medicine,
Forest Hills, NY 11375

Ph: (718) 830-4000

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