MR. ERNEST OKWUONU M.D.
NPI 1639735665
Student in an Organized Health Care Education/Training Program in Rockaway, NY

NPI Status: Active since May 15, 2019

Contact Information

327 BEACH 19TH ST.
ROCKAWAY, NY
ZIP 11691
Phone: (718) 869-7772

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  • Individual
  • Male
  • Years of Experience 8
  • Student in an Organized Health Care Educ...
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About ERNEST OKWUONU

This page provides the complete NPI Profile along with additional information for Ernest Okwuonu, a primary care provider established in Rockaway, New York with a medical specialization in Student In An Organized Health Care Education/training Program and more than 8 years of experience. The healthcare provider is registered in the NPI registry with number 1639735665 assigned on May 2019. The practitioner's primary taxonomy code is 390200000X. The provider is registered as an individual and his NPI record was last updated 6 years ago.

NPI
1639735665
Provider Name
MR. ERNEST OKWUONU M.D.
Gender
Male
Entity Type
Individual
Location Address
327 BEACH 19TH ST. ROCKAWAY, NY 11691
Location Phone
(718) 869-7772
Mailing Address
324 BEACH 19TH STREET FAR ROCKAWAY, NY 11691
Mailing Phone
(347) 535-2666
Medical School Name
OTHER
Graduation Year
2018
Is Sole Proprietor?
Yes
Enumeration Date
05-15-2019
Last Update Date
04-03-2020
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A primary care provider (PCP) like Ernest Okwuonu sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Student in an Organized Health Care Education/Training Program

Taxonomy Code
390200000X
Type
Student, Health Care
Taxonomy Description
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • BlueCare Bronze HSA Eligible $50 PCP Copay ($5 Value Based Drug List) - PPO
  • BlueCare Gold $10 PCP Copay ($5 Value Based Drug List) - PPO
  • BlueCare Silver $20 PCP Copay ($5 Value Based Drug List) - PPO
  • BlueDirect Bronze 100 HSA Eligible ($8000 Deductible / $5 Preventive Drug List) - PPO
  • BlueDirect Gold 90 HSA Eligible ($2600 Deductible / $5 Preventive Drug List) - PPO
  • BlueDirect Silver 80 HSA Eligible ($3500 Deductible / $5 Preventive Drug List) - PPO
  • BlueEssential Catastrophic 100 HSA Eligible $10600 Deductible - PPO
  • BlueValue Bronze HSA Eligible $50 PCP Copay (Standardized plan) - PPO
  • BlueValue Gold $30 PCP Copay (Standardized plan) - PPO
  • BlueValue Silver $40 PCP Copay (Standardized plan) - PPO
  • DakotaBlue Altru Gold ($5 Value Based Drug List) - PPO
  • DakotaBlue Altru Silver ($5 Value Based Drug List) - PPO
  • DakotaBlue Trinity Gold ($5 Value Based Drug List) - PPO
  • DakotaBlue Trinity Silver ($5 Value Based Drug List) - PPO
  • BridgeSpan Standard Bronze Plan - EPO
  • BridgeSpan Standard Gold Plan - EPO
  • BridgeSpan Standard Silver Plan - EPO
  • Connect 1500 Gold - EPO
  • Connect 6000 Silver - EPO
  • Connect 9800 Bronze - EPO
  • HSA Qualified 7500 Bronze - Choice Network - EPO
  • HSA-E Qualified 7500 Bronze - Signature Network - EPO
  • Providence Oregon Standard Bronze Plan - Choice Network - EPO
  • Providence Oregon Standard Bronze Plan - Signature Network - EPO
  • Providence Oregon Standard Gold Plan - Choice Network - EPO
  • Providence Oregon Standard Gold Plan - Signature Network - EPO
  • Providence Oregon Standard Silver Plan - Choice Network - EPO
  • Providence Oregon Standard Silver Plan - Signature Network - EPO
  • Bronze 8000 Individual Connect - EPO
  • Bronze Essential 9000 With 4 Copay No Deductible Office Visits Individual Connect - EPO
  • Bronze Essential 9000 With 4 Copay No Deductible Office Visits Legacy - EPO
  • Bronze HSA 7000 Individual Connect - EPO
  • Gold 2300 Individual Connect - EPO
  • Gold 2300 Legacy - EPO
  • Regence Standard Bronze Plan Individual Connect - EPO
  • Regence Standard Bronze Plan Legacy - EPO
  • Regence Standard Gold Plan Individual Connect - EPO
  • Regence Standard Gold Plan Legacy - EPO
  • Regence Standard Silver Plan Individual Connect - EPO
  • Regence Standard Silver Plan Legacy - EPO
  • Silver 6500 Individual Connect - EPO
  • Silver 6500 Legacy - EPO
  • Sanford Individual TRUE $1,750 - HMO
  • Sanford Individual TRUE $10,600 - HMO
  • Sanford Individual TRUE $3,500 - HMO
  • Sanford Individual TRUE $4,750 - HMO
  • Sanford Individual TRUE $6,500 - HMO
  • Sanford Individual TRUE $7,200 HSA Qualified - HMO
  • Sanford Individual TRUE Standardized $2,000 - HMO
  • Sanford Individual TRUE Standardized $6,000 - HMO
  • Sanford Individual TRUE Standardized $7,500 - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Ernest Okwuonu is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Ernest Okwuonu is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 7113379868

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20240117004838

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1639735665, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
3
Doubled → 6
Pos 4
9
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
3
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
6
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 7 → 14 → 5 5 → 10 → 1 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 6 + 9 + 1 + 4 + 3 + 1 + 0 + 6 + 1 + 2 + 24 = 65

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 65 is 70. The difference is the calculated check digit.

70 - 65 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1639735665.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1639735665, enumerated as an "individual" on May 15, 2019.

The provider is located at 327 BEACH 19TH ST. ROCKAWAY, NY 11691 and the phone number is (718) 869-7772.

Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

The provider might be accepting Accepts: Blue Cross Blue Shield of North Dakota, BridgeSpan. Please consult your insurance carrier or call the provider to verify.