MR. JIDEOFOR EBONY OBODOZIE MD
NPI 1124517289
Internal Medicine - Critical Care Medicine in Daytona Beach, FL

Active since May 04, 2018PECOS EnrolledAccepts Medicare Assignment
301 MEMORIAL MEDICAL PKWY, DAYTONA BEACH, FL 32117(386) 231-6000 Get Directions Write a Review

NPPES record last updated: June 9, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 9, 2024, May 4, 2018 (2 updates tracked since 2018).

About Mr. Jideofor Ebony Obodozie Md NPPES

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

MR. JIDEOFOR EBONY OBODOZIE MD (NPI 1124517289) is an individual critical care medicine provider in Daytona Beach, Florida, licensed in Florida (ME165936) and active in the NPI registry since May 2018. He is enrolled in Medicare PECOS, is affiliated with Adventhealth Orlando, and maintains a secondary practice location in Daytona Beach.

NPPES Registry Identity

NPI1124517289
Entity TypeIndividualMale
Primary Taxonomy207RC0200X
Provider Legal NameMR. JIDEOFOR EBONY OBODOZIECredential: MD
Location Address301 MEMORIAL MEDICAL PKWYDaytona Beach, FL 32117-5167
Mailing Address901 Sterthaus DrOrmond Beach, FL 32174-5133
Sole ProprietorNo
Medical School CMSOtherGraduated 2010
Enumeration DateMay 4, 2018
Last NPPES UpdateJune 9, 20242 updates tracked since enumeration
NPPES CertifiedJune 9, 2024
NPI 1124517289 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal Medicine · Critical Care MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RC0200X
License Licensed in FL · ME165936
Definition

An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.

Also ListedInternal MedicineTaxonomy 207R00000X · License 2021048898 (MO)
301 MEMORIAL MEDICAL PKWY, Daytona Beach, FL 32117

Secondary Practice Location 1

Location 1124 Colton DrDaytona Beach, FL 32117-5621 · Phone (210) 789-9296

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Mr. Jideofor Ebony Obodozie Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4183033632
PECOS Enrollment IDI20240625001438
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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
143 services80 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
39 services33 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Adventhealth Orlando

Acute Care Hospitals · Orlando, FL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100007
Location601 E Rollins StOrlando, FL 32803 · Orange County
Emergency services Birthing friendly

Adventhealth Deland

Acute Care Hospitals · Deland, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number100045
Location701 W Plymouth AveDeland, FL 32720 · Volusia County
Emergency services

Adventhealth Daytona Beach

Acute Care Hospitals · Daytona Beach, FL
5/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number100068
Location301 Memorial Medical ParkwayDaytona Beach, FL 32117 · Volusia County
Emergency services Birthing friendly

Florida Hospital Flagler

Acute Care Hospitals · Palm Coast, FL
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number100118
Location60 Memorial Medical PkwyPalm Coast, FL 32164 · Flagler County
Emergency services

Adventhealth Palm Coast Parkway

Acute Care Hospitals · Palm Coast, FL
OwnershipVoluntary non-profit - Private
CMS Certification Number100363
Location1 Adventhealth WayPalm Coast, FL 32137 · Flagler County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32117 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 19

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

Pathology (Anatomic Pathology & Clinical Pathology)
301 MEMORIAL MEDICAL PKWY
DAYTONA BEACH, FL 32117
Emergency Medicine
301 MEMORIAL MEDICAL PKWY
DAYTONA BEACH, FL 32117
Anesthesiology
301 MEMORIAL MEDICAL PKWY
DAYTONA BEACH, FL 32117
Hospitalist
301 MEMORIAL MEDICAL PKWY
DAYTONA BEACH, FL 32117
Nurse Practitioner (Family)
301 MEMORIAL MEDICAL PKWY
DAYTONA BEACH, FL 32117
Physician Assistant
301 MEMORIAL MEDICAL PKWY
DAYTONA BEACH, FL 32117
Nurse Anesthetist, Certified Registered
301 MEMORIAL MEDICAL PKWY
DAYTONA BEACH, FL 32117
Nurse Anesthetist, Certified Registered
301 MEMORIAL MEDICAL PKWY
DAYTONA BEACH, FL 32117

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1124517289, enumerated as an "individual" on May 04, 2018.

The provider is located at 301 MEMORIAL MEDICAL PKWY DAYTONA BEACH, FL 32117 and the phone number is (386) 231-6000.

Internal Medicine with taxonomy code 207RC0200X and a focus in Critical Care Medicine.

Jideofor Obodozie is affiliated with: ADVENTHEALTH ORLANDO, ADVENTHEALTH DELAND, ADVENTHEALTH DAYTONA BEACH, FLORIDA HOSPITAL FLAGLER and ADVENTHEALTH PALM COAST PARKWAY.