Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

CHINEZE EKILISIE MBANUGO MD
NPI 1063092955
Anesthesiology - Pain Medicine in Detroit, MI

Q: What is Chineze Mbanugo's NPI number?

The NPI number for Chineze Mbanugo is 1063092955. It was assigned to this individual provider in the NPPES registry on April 13, 2021.

Q: What is Chineze Mbanugo's specialty?

The primary specialty registered for this NPI is Anesthesiology, specializing in Pain Medicine, with taxonomy code 207LP2900X.

Q: When was this NPI record last updated?

The NPPES record for Chineze Mbanugo was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 13, 2021PECOS Enrolled

2799 W GRAND BLVD, DETROIT, MI 48202(313) 916-1601 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 13, 2026, Apr 25, 2026, Apr 13, 2022 and 1 more (4 updates tracked since 2021).

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About Chineze Ekilisie Mbanugo Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHINEZE EKILISIE MBANUGO MD (NPI 1063092955) is an individual pain medicine provider in Detroit, Michigan, licensed in Illinois (036180871) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1063092955

Entity TypeIndividualFemale

Primary Taxonomy207LP2900X

Provider Legal NameCHINEZE EKILISIE MBANUGOCredential: MD

Location Address2799 W GRAND BLVDDetroit, MI 48202-2689

Mailing Address600 S Paulina StChicago, IL 60612-3806 · (313) 942-7100

Phone(313) 916-1601

Sole ProprietorYes

Enumeration DateApril 13, 2021

Last NPPES UpdateJuly 13, 20264 updates tracked since enumeration

NPPES CertifiedJuly 13, 2026

✔ NPI 1063092955 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiology · Pain MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207LP2900X

License✔ Licensed in IL · 036180871

Definition

An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists.

2799 W GRAND BLVD, Detroit, MI 48202

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Secondary Practice Locations 2

Location 115 Michigan St NEGrand Rapids, MI 49503-2508 · Phone (734) 620-5578

Location 2600 S Paulina StChicago, IL 60612-3806 · Phone (312) 942-7100

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Chineze Ekilisie Mbanugo Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HENRY FORD HOSPITAL

General Acute Care Hospital