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CHINENYE VIVIAN EZEMBAMALU NP
NPI 1952261174
Nurse Practitioner in Green Bay, WI

Active since November 12, 2025PECOS EnrolledAccepts Medicare Assignment
1860 SHAWANO AVE, GREEN BAY, WI 54303(920) 496-4700 Get Directions Write a Review

NPPES record last updated: July 8, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 8, 2026, Nov 12, 2025 (2 updates tracked since 2025).

About Chinenye Vivian Ezembamalu Np NPPES

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

CHINENYE VIVIAN EZEMBAMALU NP (NPI 1952261174) is an individual nurse practitioner in Green Bay, Wisconsin, licensed in Wisconsin (17814-33) and active in the NPI registry since November 2025. She is enrolled in Medicare PECOS, is affiliated with St Vincent Hospital, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1952261174
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameCHINENYE VIVIAN EZEMBAMALUCredential: NP
Location Address1860 SHAWANO AVEGreen Bay, WI 54303-2667
Mailing AddressPo Box 19070Green Bay, WI 54307-9070 · (920) 496-4700
Phone(920) 496-4700
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateNovember 12, 2025
Last NPPES UpdateJuly 8, 20262 updates tracked since enumeration
NPPES CertifiedJuly 8, 2026
✔ NPI 1952261174 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in WI · 17814-33
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
1860 SHAWANO AVE, Green Bay, WI 54303
Open in Google Maps ↗

Other Identifiers 1

Medicaid100405772WI

Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Chinenye Vivian Ezembamalu Np 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 ID3173090669
PECOS Enrollment IDI20260422000106
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 Reassignments

3

Medicare enrollment records show Chinenye Ezembamalu reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

St. Clare Memorial Hospital, Inc.
3.8 mi
Surgery
900 S WEBSTER AVE
Green Bay, WI 54301
  • Reassigned Medicare billing, Wisconsin enrollment
  • 216 clinicians in this Medicare group
NPI 1093173791 (920) 965-7411
St Vincent Hospital-Hospital Sisters-Third Order Of St Francis
3.8 mi
General Practice
2710 EXECUTIVE DR
Green Bay, WI 54304
  • Reassigned Medicare billing, Wisconsin enrollment
  • 742 clinicians in this Medicare group
NPI 1285613638 (920) 433-8287
St. Nicholas Hospital-Sisters Of The Third Order Of St Francis
56 mi
Internal Medicine
3113 SAEMANN AVE
Sheboygan, WI 53081
  • Reassigned Medicare billing, Wisconsin enrollment
  • 673 clinicians in this Medicare group
NPI 1275799413 (920) 496-4700

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

Hospital Affiliations CMS Care Compare 2

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

St Vincent Hospital

Acute Care Hospitals · Green Bay, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number520075
Location835 S Van Buren StGreen Bay, WI 54301 · Brown County
Emergency services Birthing friendly

St Mary's Hospital Medical Center

Acute Care Hospitals · Green Bay, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number520097
Location1726 Shawano AveGreen Bay, WI 54303 · Brown County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54303 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
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.

KADIE RAE BIESE AUD
Audiologist
1860 SHAWANO AVE
GREEN BAY, WI 54303
Brown County (920) 496-4700
MATTHEW JOHN SPRISTER APNP
Nurse Practitioner (Family)
1860 SHAWANO AVE
GREEN BAY, WI 54303
Brown County (920) 496-4700
JOSIE R DOXTATER AU.D.
Audiologist
1860 SHAWANO AVE
GREEN BAY, WI 54303
Brown County (920) 405-1414
TARA LEIGH BENSON APNP
Nurse Practitioner (Family)
1860 SHAWANO AVE
GREEN BAY, WI 54303
Brown County (920) 429-1700
ANN M LAAKE MD
Internal Medicine (Infectious Disease)
1860 SHAWANO AVE
GREEN BAY, WI 54303
Brown County (920) 496-4700
KWABENA OWARE ADU-GYAMFI MD
Internal Medicine (Gastroenterology)
1860 SHAWANO AVE
GREEN BAY, WI 54303
Brown County (920) 496-4700
DR. ALEXANDER C BARR MD
Otolaryngology
1860 SHAWANO AVE
GREEN BAY, WI 54303
Brown County (920) 496-4700
KYLE M ERIKS CLINE NP
Nurse Practitioner (Family)
1860 SHAWANO AVE
GREEN BAY, WI 54303
Brown County (920) 496-4700

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 Chinenye Ezembamalu's NPI number?

The NPI number for Chinenye Ezembamalu is 1952261174. It was assigned to this individual provider in the NPPES registry on November 12, 2025.

Where is Chinenye Ezembamalu located?

Chinenye Ezembamalu practices at 1860 Shawano Ave, Green Bay, WI 54303. The listed phone number is (920) 496-4700.

What is Chinenye Ezembamalu's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Chinenye Ezembamalu enrolled in Medicare?

Yes. Chinenye Ezembamalu is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Chinenye Ezembamalu's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Chinenye Ezembamalu reassigns Medicare benefits to 3 organizations: St. Clare Memorial Hospital, Inc. (Green Bay, WI), St Vincent Hospital-Hospital Sisters-Third Order Of St Francis (Green Bay, WI) and St. Nicholas Hospital-Sisters Of The Third Order Of St Francis (Sheboygan, WI). Each 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 Chinenye Ezembamalu's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Chinenye Ezembamalu accept?

Health plans from Anthem Blue Cross and Blue Shield, Dean Health Plan, Network Health and Security Health Plan list Chinenye Ezembamalu 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.

Is Chinenye Ezembamalu affiliated with any hospitals?

According to CMS data, Chinenye Ezembamalu is affiliated with St Vincent Hospital and St Mary's Hospital Medical Center.

When was this NPI record last updated?

The NPPES record for Chinenye Ezembamalu was last updated on July 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.