Individual provider Active NPI

Oritsetimeyin E Otubu-Scipio, M.D.

  • Family Medicine Physician
  • New Berlin, WI
National Provider Identifier
1023062684
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
102411-875 Issued in WI
Practice address
14555 W National Ave
New Berlin, WI 53151-4494
Phone
(844) 284-0381
NPI assigned
May 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 102411-875 WI Primary
Family Medicine Physician 207Q00000X T5422 TX
Family Medicine Physician 207Q00000X 2022011593 MO
Family Medicine Physician 207Q00000X 01087389A IN
Family Medicine Physician 207Q00000X 65342 CT
Family Medicine Physician 207Q00000X 35.139913 OH
Family Medicine Physician 207Q00000X 0101265021 VA
Family Medicine Physician 207Q00000X 2018-01735 NC
Family Medicine Physician 207Q00000X 51978 KY
Family Medicine Physician 207Q00000X 70814 MN
Family Medicine Physician 207Q00000X 19570 SC
Family Medicine Physician 207Q00000X 036174163 IL
Family Medicine Physician 207Q00000X C159878 CA
Family Medicine Physician 207Q00000X ME146470 FL
Family Medicine Physician 207Q00000X MD466228 PA

Addresses

Primary practice location

14555 W National Ave
New Berlin, WI 53151-4494

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other practice location 1

1 California St Ste 2300
San Francisco, CA 94111-5424
Phone (800) 997-6196

Other practice location 2

1441 Branding Ave Ste 310
Downers Grove, IL 60515-5624
Phone (262) 693-4311

Other identifiers 3

IdentifierTypeStateIssuer
5911258MedicaidNC
100301311MedicaidWI
197500MedicaidSC

Electronic endpoints 4

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address ootubuscipio417654@direct.myadvocateaurora.org Direct
Direct Messaging Address ootubuscipio417654@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250116000094 WI Practitioner - Family Practice 6406865229 Reassigns benefits to 3 organizations
I20250410003079 IL Practitioner - Family Practice 6406865229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Drexel University College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians
Advocate Health and Hospitals CorporationGroup PAC ID 7810800935, 3,081 clinicians

Practice addresses (Care Compare)

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

1441 Branding Ave
Downers Grove, IL 60515-5624
Phone (630) 829-1084

14555 W National Ave
195B
New Berlin, WI 53151-4494
Phone (262) 827-3290

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C159878CAMDFamily Medicine Physician
65342CTMDFamily Medicine Physician
ME146470FLMDFamily Medicine Physician
036174163ILMDFamily Medicine Physician
01087389AINMDFamily Medicine Physician
70814MNMDFamily Medicine Physician
2022011593MOMDFamily Medicine Physician
2018-01735NCMDFamily Medicine Physician
35.139913OHMDFamily Medicine Physician
T5422TXMDFamily Medicine Physician
19570SCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Medical Clinic, LLC Family Medicine CurrentSince Jan 1, 2025 Accepting new patients
Aurora Advanced Healthcare, Inc. Family Medicine CurrentSince Jan 1, 2025 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Mar 4, 2025 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Jan 1, 2025 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Aurora Medical Group, Inc. Family Medicine Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Mar 4, 2025 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients
Carolina Health Centers, Inc. Family Medicine Past Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

75 Remittance Dr
Dept 6764
Chicago, IL 60675

1441 Branding Ave
Ste 310
Downers Grove, IL 60515
Phone (630) 829-1038

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

14555 W National Ave
New Berlin, WI 53151
Phone (262) 827-2900

200 E Ryan Rd
Oak Creek, WI 53154
Phone (414) 570-3590

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1023062684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14555 W NATIONAL AVE",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531514494",
            "telephone_number": "844-284-0381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 California St Ste 2300",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941115424",
            "country_code": "US",
            "telephone_number": "800-997-6196",
            "fax_number": "415-504-1367",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1441 Branding Ave Ste 310",
            "address_purpose": "LOCATION",
            "city": "Downers Grove",
            "state": "IL",
            "postal_code": "605155624",
            "country_code": "US",
            "telephone_number": "262-693-4311",
            "fax_number": "414-293-3788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTUBU-SCIPIO",
        "first_name": "ORITSETIMEYIN",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "102411-875",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "T5422",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2022011593",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01087389A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "65342",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.139913",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101265021",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2018-01735",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "51978",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "70814",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "19570",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036174163",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C159878",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME146470",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD466228",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5911258",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100301311",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197500",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "14555 W National Ave",
            "city": "New Berlin",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531514494",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ootubuscipio417654@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "14555 W National Ave",
            "city": "New Berlin",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531514494",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ootubuscipio417654@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1441 Branding Ave Ste 310",
            "city": "Downers Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605155624",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1441 Branding Ave Ste 310",
            "city": "Downers Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605155624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New Berlin, WI

Sources for this page

Verify at the official NPI Registry.