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

EMMANUELLA EGBONIM MPH
NPI 1255969598
Internal Medicine - Cardiovascular Disease in Fort Worth, TX

Active since March 31, 2020PECOS Enrolled
600 S MAIN ST, FORT WORTH, TX 76104(817) 882-2420 Get Directions Write a Review

NPPES record last updated: September 15, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 15, 2026, Sep 4, 2026, Mar 31, 2020 (3 updates tracked since 2020).

About Emmanuella Egbonim Mph NPPES

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

EMMANUELLA EGBONIM MPH (NPI 1255969598) is an individual cardiovascular disease provider in Fort Worth, Texas, licensed in Texas (U3204) and active in the NPI registry since March 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1255969598
Entity TypeIndividualFemale
Primary Taxonomy207RC0000X
Provider Legal NameEMMANUELLA EGBONIMCredential: MPH
Location Address600 S MAIN STFort Worth, TX 76104-2410
Mailing AddressPo Box 845347Dallas, TX 75284-7208
Phone(817) 882-2420
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateMarch 31, 2020
Last NPPES UpdateSeptember 15, 20263 updates tracked since enumeration
NPPES CertifiedSeptember 15, 2026
✔ NPI 1255969598 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
License✔ Licensed in TX · U3204
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
600 S MAIN ST, Fort Worth, TX 76104
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Emmanuella Egbonim Mph is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8426518895
PECOS Enrollment IDI20260904000184
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 Emmanuella Egbonim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

University Of Texas Southwestern Medical Center At Dallas
Same address
Ophthalmology
600 S MAIN ST
Fort Worth, TX 76104
  • Reassigned Medicare billing, Texas enrollment
  • 5,299 clinicians in this Medicare group
NPI 1225082050 (817) 882-2400

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 76104 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
$129.63 typical visit price
range $56.47 – $171.07
Typical copayment $32.40 (range $14.11 – $42.76)
Most-billed visit code 99204
Established Patient
$70.45 typical visit price
range $18.18 – $139.68
Typical copayment $17.61 (range $4.54 – $34.92)
Most-billed visit code 99213
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.

DR. ILENE CHIU M.D.
Otolaryngology
600 S MAIN ST
FORT WORTH, TX 76104
Tarrant County (817) 882-2400
GAYANE TUMYAN MD
Internal Medicine (Endocrinology, Diabetes & Metabolism)
600 S MAIN ST
FORT WORTH, TX 76104
Tarrant County (817) 882-2420
DR. SHANDRA BANKS PHARMD, RPH
Pharmacist
600 S MAIN ST
FORT WORTH, TX 76104
Tarrant County (817) 882-2500
LINDSEY MARTIN OTR/L
Occupational Therapist
600 S MAIN ST
FORT WORTH, TX 76104
Tarrant County (817) 882-2400
DR. LUIGINO ROLANDO MATEO BERNABELA M.D
Internal Medicine (Rheumatology)
600 S MAIN ST
FORT WORTH, TX 76104
Tarrant County (817) 882-2425
DR. JAMIE ARTHUR NIVENS D.O.
Family Medicine
600 S MAIN ST
FORT WORTH, TX 76104
Tarrant County (214) 648-8388
UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS
Ophthalmology
600 S MAIN ST
FORT WORTH, TX 76104
Tarrant County (817) 882-2400
SHELLY M HARVEY MD
Allergy & Immunology
600 S MAIN ST
FORT WORTH, TX 76104
Tarrant County (817) 882-2400

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Emmanuella Egbonim's NPI number?

The NPI number for Emmanuella Egbonim is 1255969598. It was assigned to this individual provider in the NPPES registry on March 31, 2020.

Where is Emmanuella Egbonim located?

Emmanuella Egbonim practices at 600 S Main St, Fort Worth, TX 76104. The listed phone number is (817) 882-2420.

What is Emmanuella Egbonim's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Emmanuella Egbonim enrolled in Medicare?

Yes. Emmanuella Egbonim is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Emmanuella Egbonim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Emmanuella Egbonim reassigns Medicare benefits to University Of Texas Southwestern Medical Center At Dallas (Fort Worth, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Emmanuella Egbonim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Emmanuella Egbonim accept?

Health plans from Blue Cross and Blue Shield of Texas list Emmanuella Egbonim as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Emmanuella Egbonim was last updated on September 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 39 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.