Individual provider Active NPI

Paul Obeng-Okyere, D.O

  • Cardiovascular Disease Physician
  • Miamisburg, OH
National Provider Identifier
1033504170
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
0102207269 Issued in VA
Practice address
2115 Leiter Rd
Miamisburg, OH 45342
Phone
(937) 384-6800
Fax
(937) 384-6938
NPI assigned
Apr 6, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X 0102207269 VA Primary
Internal Medicine Physician 207R00000X 34.013217 OH

Addresses

Primary practice location

2115 Leiter Rd
Miamisburg, OH 45342

Mailing address

612 Kingsborough SQ
Ste 100
Chesapeake, VA 23320-5041
Phone (413) 652-8185

Other identifiers 1

IdentifierTypeStateIssuer
0285134MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220908000157 VA Practitioner - Cardiovascular Disease (Cardiology) 9234442500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Ohio University, College of Osteopathic Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bayview Physician Services PCGroup PAC ID 5597664201, 311 clinicians

Practice addresses (Care Compare)

612 Kingsborough SQ
Suite 100
Chesapeake, VA 23320-5041
Phone (757) 547-9294

Hospital & facility affiliations

  • Sentara Virginia Beach General Hospital Hospital, Virginia Beach, VA, CCN 490057
  • Chesapeake General Hospital Hospital, Chesapeake, VA, CCN 490120
  • Sentara Princess Anne Hospital Hospital, Virginia Beach, VA, CCN 490119
  • Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0102207269VAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bayview Physician Services, PC Multi-Specialty CurrentSince Sep 1, 2022 Accepting new patients
Bayview Physician Services, PC CurrentSince Sep 1, 2022 Accepting new patients
Bayview Medical Center, Inc Past Accepting new patients

Locations

3241 Western Branch Blvd
Ste A
Chesapeake, VA 23321

111 Mill Creek Pkwy
Chesapeake, VA 23323
Phone (757) 558-8210

3241 Western Branch Blvd
Chesapeake, VA 23321
Phone (757) 686-3500

612 Kingsborough Sq
Ste 100
Chesapeake, VA 23320
Phone (757) 547-9294

2000 Meade Pkwy
Ste 195
Suffolk, VA 23434

4868 Bridge Rd
Ste 300
Suffolk, VA 23435
Phone (757) 483-7100

2075 Glenn Mitchell Dr
Ste 300
Virginia Beach, VA 23456
Phone (757) 821-2825

1708 Old Donation Pkwy
Virginia Beach, VA 23454
Phone (757) 395-5300

Interoperability endpoints

  • Direct secure messaging: pobengokyere1357360@direct.bsmhealth.org

Organizations & group practices 3

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1033504170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 KINGSBOROUGH SQ",
            "address_2": "STE 100",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233205041",
            "telephone_number": "413-652-8185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 LEITER RD",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "45342",
            "telephone_number": "937-384-6800",
            "fax_number": "937-384-6938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBENG-OKYERE",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-06",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": "0102207269",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34.013217",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0285134",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miamisburg, OH

Sources for this page

Verify at the official NPI Registry.