Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. PRINCESS AMAKA IKEMENOGO MD
NPI 1225603897
Psychiatry & Neurology - Neurology in Conyers, GA

Q: What is Princess Ikemenogo's NPI number?

The NPI number for Princess Ikemenogo is 1225603897. It was assigned to this individual provider in the NPPES registry on May 25, 2021.

Q: What is Princess Ikemenogo's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Active since May 25, 2021PECOS Enrolled

1412 MILSTEAD AVE NE, CONYERS, GA 30012(470) 788-1010 Get Directions Write a Review

NPPES record last updated: October 8, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 8, 2026, May 25, 2021 (2 updates tracked since 2021).

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About Dr. Princess Amaka Ikemenogo Md NPPES

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

DR. PRINCESS AMAKA IKEMENOGO MD (NPI 1225603897) is an individual neurology provider in Conyers, Georgia, licensed in Georgia (113680) and active in the NPI registry since May 2021. She is enrolled in Medicare PECOS, maintains a secondary practice location in Seattle, and is a graduate of Meharry Medical College School Of Medicine (2021).

NPPES Registry Identity

NPI1225603897

Entity TypeIndividualFemale

Primary Taxonomy2084N0400X

Provider Legal NameDR. PRINCESS AMAKA IKEMENOGOCredential: MD

Location Address1412 MILSTEAD AVE NEConyers, GA 30012-3877

Mailing Address1959 Ne Pacific StSeattle, WA 98195-0001 · (206) 543-2340

Phone(470) 788-1010

Sole ProprietorNo

Medical School CMSMeharry Medical College School Of MedicineGraduated 2021

Enumeration DateMay 25, 2021

Last NPPES UpdateOctober 8, 20262 updates tracked since enumeration

NPPES CertifiedOctober 8, 2026

✔ NPI 1225603897 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians

Taxonomy Code2084N0400X

Licenses✔ Licensed in GA · 113680✔ Licensed in WA · 70006606

Definition

A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

1412 MILSTEAD AVE NE, Conyers, GA 30012

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Secondary Practice Location 1

Location 11959 NE Pacific StSeattle, WA 98195-4923 · Phone (206) 543-2340

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Princess Amaka Ikemenogo Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9537569637

PECOS Enrollment IDI20260727002027

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.

Medicare Billing Reassignment

Medicare enrollment records show Princess Ikemenogo reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Piedmont Hospitalist Physicians LLC

17 mi

Family Medicine

1133 EAGLES LANDING PKWY
Stockbridge, GA 30281

Reassigned Medicare billing, Georgia enrollment
792 clinicians in this Medicare group

NPI 1548219660 (770) 801-2500

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30012 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

$130.64 typical visit price

range $56.84 – $172.43

Typical copayment $32.66 (range $14.21 – $43.10)

Most-billed visit code 99204

Established Patient

$100.20 typical visit price

range $18.22 – $140.40

Typical copayment $25.05 (range $4.55 – $35.10)

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 20

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

WALKER LAKE PHYSICIAN SERVICES, PC

Hospitalist