Samuel Omorogbe, NURSE PRACTITIONER

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP142663 Issued in TX

Practice address

7908 Modesto Dr
Arlington, TX 76001-6102

Phone

(817) 501-4559

NPI assigned

Aug 21, 2019

Last updated

Aug 21, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• NA NA NA Professional name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

79.54 of 100Reported as group

Quality

72.94

Improvement activities

40

Cost

48.08

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Chatel Behavioral Healthcare LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Arlington, TX
  • NPI 1003421421
  Medicare reassignment NPD Authorized official
• Med Management Associates

  • Psychiatry Physician
  • San Antonio, TX
  • NPI 1508233040
  Medicare reassignment NPD
• Scof Enterprise Inc

  dba d/b/a SCOF Healthcare Providers

  • Home Health Agency
  • Arlington, TX
  • NPI 1306983309
  NPD (past)

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

{
    "created_epoch": "1566345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566345600000",
    "number": "1083261390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7908 MODESTO DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760016102",
            "telephone_number": "817-501-4559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7908 MODESTO DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760016102",
            "telephone_number": "817-501-4559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMOROGBE",
        "first_name": "SAMUEL",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-21",
        "last_updated": "2019-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP142663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Arlington",
            "affiliation": "N",
            "endpointDescription": "Record",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Arlington",
            "address_1": "7908 Modesto Dr",
            "city": "Arlington",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760016102",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Arlington",
            "affiliation": "N",
            "endpointDescription": "record",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Arlington",
            "address_1": "7908 Modesto Dr",
            "city": "Arlington",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760016102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NA",
            "last_name": "NA",
            "middle_name": "NA",
            "credential": "PMHNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Omnimind Mental Health, PLLC
• Omnitransit LLC
• Paulina Omoba
• Victoria O Omondi, RN,MSN
• Marie Monyato Omorogbe, NP
• James Arimoku Omoruyi, LVN
• Yewande A. Omowanile, M.D.
• Callen Omurwa, PMHNP
• On the Dot Drug Testing Services
• On Time Transit LLC

• Psychiatric/Mental Health Nurse Practitioner in Arlington, TX
• Providers in Arlington, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2019; 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.