Active NPI
Olegario J Ignacio Jr., MD
- Specialist
- Jeffersonville, IN
National Provider Identifier
1063407708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 26117
- Practice address
- 1035 Wall St
Suite 207
Jeffersonville, IN 47130-3612 - Phone
- (812) 282-1351
- Fax
- (812) 283-5758
- NPI assigned
- Sep 19, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 26117 | IN | Primary |
Addresses
Primary practice location
1035 Wall St
Suite 207
Jeffersonville, IN 47130-3612
Mailing address
1035 Wall St
Ste 207
Jeffersonville, IN 47130-3612
Phone (812) 282-1351
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 130005449 | Other | IN | MEDICARE RAILROAD |
| 000000042379 | Other | IN | ANTHEM/BLUE CROSS |
| 100074770A | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26117 | IN | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Indiana Neurology Associates, Inc. | Specialist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Specialist
- Jeffersonville, IN
- NPI 1619068194
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209513600000",
"number": "1063407708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1035 WALL ST",
"address_2": "STE 207",
"city": "JEFFERSONVILLE",
"state": "IN",
"postal_code": "471303612",
"telephone_number": "812-282-1351",
"fax_number": "812-283-5758"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1035 WALL ST",
"address_2": "SUITE 207",
"city": "JEFFERSONVILLE",
"state": "IN",
"postal_code": "471303612",
"telephone_number": "812-282-1351",
"fax_number": "812-283-5758"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IGNACIO",
"first_name": "OLEGARIO",
"middle_name": "J",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-19",
"last_updated": "2008-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "IN",
"license": "26117",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "130005449",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM/BLUE CROSS",
"identifier": "000000042379",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100074770A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jeffersonville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.