MBONU NNAJI IKEZUAGU M.D.
NPI 1871721696
Internal Medicine in Appleton, WI

Q: What is Mbonu Ikezuagu's NPI number?

The NPI number for Mbonu Ikezuagu is 1871721696. It was assigned to this individual provider in the NPPES registry on July 1, 2009.

Q: What is Mbonu Ikezuagu's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Mbonu Ikezuagu was last updated on September 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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 July 01, 2009PECOS EnrolledAccepts Medicare Assignment

3925 N GATEWAY DR, APPLETON, WI 54913(920) 702-6371 Get Directions Write a Review

NPPES record last updated: September 4, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Mbonu Nnaji Ikezuagu M.d. NPPES

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

MBONU NNAJI IKEZUAGU M.D. (NPI 1871721696) is an individual internal medicine provider in Appleton, Wisconsin, licensed in Wisconsin (81640) and active in the NPI registry since July 2009. He is enrolled in Medicare PECOS, is affiliated with Thedacare Medical Center - New London, and is a graduate of Other (2008).

NPPES Registry Identity

NPI1871721696

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameMBONU NNAJI IKEZUAGUCredential: M.D.

Location Address3925 N GATEWAY DRAppleton, WI 54913-7863

Mailing Address3 Neenah CtrNeenah, WI 54956-3070 · (920) 702-6371 · Fax (920) 993-5037

Phone(920) 702-6371

Sole ProprietorNo

Medical School CMSOtherGraduated 2008

Enumeration DateJuly 1, 2009

Last NPPES UpdateSeptember 4, 2024

NPPES CertifiedSeptember 4, 2024

✔ NPI 1871721696 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Licenses✔ Licensed in WI · 81640✔ Licensed in OH · 35-099233

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedHospitalistTaxonomy 208M00000X · License 81640 (WI)

3925 N GATEWAY DR, Appleton, WI 54913

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Other Identifiers 2

Medicaid0067250OH

Other35-099233OH · Ohio Medical License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource and more.Insurance ›

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

Mbonu Nnaji Ikezuagu M.d. 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 ID8527223858

PECOS Enrollment IDI20231116000594

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.

Hospital Affiliations CMS Care Compare

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

Thedacare Medical Center - New London

Critical Access Hospitals · New London, WI

OwnershipVoluntary non-profit - Private

CMS Certification Number521326

Location1405 Mill StNew London, WI 54961 · Waupaca County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54913 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

$123.69 typical visit price

range $53.90 – $163.24

Typical copayment $30.92 (range $13.47 – $40.81)

Most-billed visit code 99204

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

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.

FOX VALLEY HEMATOLOGY & ONCOLOGY S C

Pharmacy (Community/Retail Pharmacy)

3925 N GATEWAY DR, SUITE 100
APPLETON, WI 54913

Outagamie County (920) 702-4802

BRITTANY E GOODRICH-BRAUN

Family Medicine