NPIMap

Individual provider Active NPI

Clarence O Ojo, MD

  • Vascular Surgery Physician
  • St. Cloud, MN
National Provider Identifier
1053650630
Registry record updated Dec 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
63732 Issued in MN
Practice address
1200 6TH Ave. N.
St. Cloud, MN 56303-2735
Phone
(320) 252-3342
Fax
(320) 252-3501
NPI assigned
Feb 2, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 63732 MN Primary

Addresses

Primary practice location

1200 6TH Ave. N.
St. Cloud, MN 56303-2735

Mailing address

1200 6TH Ave. N.
St. Cloud, MN 56303-2735
Phone (320) 252-3342

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180810003100 MN Practitioner - Vascular Surgery 3072747021 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Albany Medical College of Union University, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centracare ClinicGroup PAC ID 2466363395, 800 clinicians

Practice addresses (Care Compare)

1200 6TH Ave N
Centracare Clic River Campus
Saint Cloud, MN 56303-2735
Phone (320) 252-5131

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal38
Leg revascularization (restoring blood flow)72
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
63732MNMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Health System-NR LLC CurrentSince Jul 1, 2021 Accepting new patients
Centracare Health System - Sauk Centre CurrentSince Aug 27, 2018 Accepting new patients
Centracare Health-Paynesville LLC CurrentSince Aug 27, 2018 Accepting new patients
Centracare Health-Paynesville LLC CurrentSince Aug 27, 2018 Accepting new patients
Centracare Clinic CurrentSince Aug 27, 2018 Accepting new patients
Centracare Health System-NR LLC Current Accepting new patients
Centracare Health System - Sauk Centre CurrentSince Aug 27, 2018 Accepting new patients
Centracare Clinic CurrentSince Aug 27, 2018 Accepting new patients
Centracare Clinic Current Accepting new patients
Centracare Health System - Melrose CurrentSince Aug 27, 2018 Accepting new patients
Centracare Health System - Sauk Centre Current Accepting new patients
Centracare Health System - Melrose CurrentSince Aug 27, 2018 Accepting new patients
Centracare Health-Paynesville LLC Current Accepting new patients
Centracare Clinic Past Accepting new patients
St. Cloud Hospital Past Accepting new patients

Locations

525 Main St W
Melrose, MN 56352
Phone (320) 256-4228

1013 Hart Blvd
Monticello, MN 55362
Phone (763) 271-2303

200 W 1st St
Paynesville, MN 56362
Phone (320) 243-3767

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422

425 Elm St N
Sauk Centre, MN 56378
Phone (320) 352-2221

Interoperability endpoints

  • Direct secure messaging: cojo413758@direct.centracare.com

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1359763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543881600000",
    "number": "1053650630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 6TH AVE. N.",
            "city": "ST. CLOUD",
            "state": "MN",
            "postal_code": "563032735",
            "telephone_number": "320-252-3342",
            "fax_number": "320-252-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 6TH AVE. N.",
            "city": "ST. CLOUD",
            "state": "MN",
            "postal_code": "563032735",
            "telephone_number": "320-252-3342",
            "fax_number": "320-252-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OJO",
        "first_name": "CLARENCE",
        "middle_name": "O",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-02",
        "last_updated": "2018-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MN",
            "license": "63732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Cloud, MN

Sources for this page

Verify at the official NPI Registry.