Individual provider Active NPI

Maurice L Oehlsen, M.D.

  • Diagnostic Radiology Physician
  • Utica, NY
National Provider Identifier
1053303917
Registry record updated Mar 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
214421 Issued in NY
Practice address
2209 Genesee St
Utica, NY 13501-5930
Phone
(315) 798-8171
Fax
(315) 734-3084
NPI assigned
Aug 17, 2005
Last updated
Mar 12, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 214421 NY Primary

Addresses

Primary practice location

2209 Genesee St
Utica, NY 13501-5930

Mailing address

4567 Crossroads Park Dr
2ND Floor
Liverpool, NY 13088-3589
Phone (315) 295-2100

Other identifiers 1

IdentifierTypeStateIssuer
01958474MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, OH2 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
I20050603000862 NY Practitioner - Diagnostic RadiologyPractitioner - Radiation Oncology 3375586027 Reassigns benefits to 1 organization
I20241113000468 OH Practitioner - Internal Medicine 3375586027 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Metrohealth SystemGroup PAC ID 8628982949, 1,150 clinicians

Practice addresses (Care Compare)

2500 Metrohealth Dr
Cleveland, OH 44109-1900
Phone (216) 778-7800

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Metrohealth System Diagnostic Radiology CurrentSince Nov 27, 2024 Accepting new patients
Millennium Medical Imaging PC Diagnostic Radiology CurrentSince Jul 7, 2018 Accepting new patients
Lumina Imaging Diagnostic Radiology CurrentSince Nov 27, 2024 Accepting new patients
The Metrohealth System Current Accepting new patients
The Metrohealth System CurrentSince Nov 27, 2024 Accepting new patients

Locations

169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111

211 Church St
Saratoga Springs, NY 12866
Phone (518) 583-8461

2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348

30400 Detroit Rd
Ste 101
Westlake, OH 44145
Phone (440) 592-6065

Interoperability endpoints

  • Direct secure messaging: moehlsen297801@direct.metrohealth.org

Organizations & group practices 5

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

Hospital & facility affiliations 2

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": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205280000000",
    "number": "1053303917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4567 CROSSROADS PARK DR",
            "address_2": "2ND FLOOR",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883589",
            "telephone_number": "315-295-2100",
            "fax_number": "315-295-2125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2209 GENESEE ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135015930",
            "telephone_number": "315-798-8171",
            "fax_number": "315-734-3084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OEHLSEN",
        "first_name": "MAURICE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2008-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "214421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01958474",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

Verify at the official NPI Registry.