Okosun Edoro, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

320247-01 Issued in NY

Practice address

5700 W Genesee St Ste 109
Camillus, NY 13031-3226

Phone

(315) 487-1573

Fax

(315) 487-2418

NPI assigned

Jul 16, 2007

Last updated

Jan 18, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Internal Medicine

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Familycare Medical Group PCGroup PAC ID 5193639565, 110 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Liverpool, NY, CCN 337255
• Hospice of Central New York Hospice, Liverpool, NY, CCN 331511
• University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. 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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eokosun@fcmg.medentdirect.com

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.

• Familycare Medical Group, PC

  • Family Medicine Physician
  • Syracuse, NY
  • NPI 1447212063

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Chikare Health Services Inc

  dba Immanuel Family Health Center

  • Primary Care Clinic/Center
  • East Chicago, IN
  • NPI 1043375934
  NPD (past)
• Chikare Health System PC

  • Federally Qualified Health Center (FQHC)
  • East Chicago, IN
  • NPI 1285298067
  NPD (past)

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

• QC-Medi New York, Inc.

  dba CenterWell Home Health

  • Home Health Agency
  • Syracuse, NY
  • NPI 1912939489
  Care Compare affiliation
• Suny Health Science Center at Syracuse

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1578554630
  Care Compare affiliation
• The Caring Coalition of Central New York

  dba Hospice of Central New York

  • Community Based Hospice Care Agency
  • Liverpool, NY
  • NPI 1912098666
  Care Compare affiliation

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1063611481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 W GENESEE ST STE 109",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130313226",
            "telephone_number": "315-487-1573",
            "fax_number": "315-487-2418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 W GENESEE ST STE 109",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130313226",
            "telephone_number": "315-487-1573",
            "fax_number": "315-487-2418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDORO",
        "first_name": "OKOSUN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-16",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD11918",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2015-02505",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "320247-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert K Druger, M.D., PHD
• Kimberly Bridget Dunham, MS CCC/SLP
• Jessica Dussing
• Eckerd Corporation (Rite Aid Pharmacy 10733)
• Scott A Edison, MD
• Justin Robert Edwards, OPTICIAN
• Emerging Vision Inc
• Encore Physical Therapy, PLLC
• Ashley Engelbrecht, RN
• Marc Darren Engle, D.D.S.

• Internal Medicine Physician in Camillus, NY
• Providers in Camillus, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.