Individual provider Active NPI

Prisca John-Ogam

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1093336315
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
360 Huntington Ave
Boston, MA 02115-5005
Phone
(347) 684-6498
NPI assigned
Apr 27, 2020
Last updated
Mar 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

360 Huntington Ave
Boston, MA 02115-5005

Mailing address

4136 Billy Mitchell Dr
Addison, TX 75001-4350
Phone (347) 684-6498

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20221123001695 TX Practitioner - Physician Assistant 7416325444 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primamed Physicians, PLLCGroup PAC ID 9234027897, 62 clinicians

Practice addresses (Care Compare)

1213 E Trinity Mills Rd
Suite 100
Carrollton, TX 75006-1446
Phone (972) 431-0820

1920 Eldorado Pkwy
Suite 100
McKinney, TX 75069-7962
Phone (469) 952-3737

3304 Alma Dr
Plano, TX 75023-7333
Phone (972) 424-6581

5076 W Plano Pkwy
Plano, TX 75093-5009
Phone (972) 733-0095

540 Surf St
Lewisville, TX 75067-3526
Phone (972) 420-9900

7910 Belt Line Rd
Dallas, TX 75254-8130
Phone (972) 980-6753

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Urgent Care Current Accepting new patients
Primamed Physicians PLLC CurrentSince Dec 22, 2022 Accepting new patients
Texas Health Urgent Care CurrentSince Feb 1, 2023 Accepting new patients
Texas Health Urgent Care Physician Assistant Current Accepting new patients
Texas Health Urgent Care CurrentSince Feb 1, 2023 Accepting new patients
Citimed, P.a. Past Accepting new patients

Locations

4401 Little Rd
Ste 520
Arlington, TX 76016
Phone (682) 318-3114

11888 Marsh Ln
Ste 104
Dallas, TX 75234
Phone (972) 488-9222

6411 E Northwest Hwy
Dallas, TX 75231
Phone (469) 495-9110

3304 Alma Dr
Plano, TX 75023
Phone (972) 424-6581

125 Davis Blvd
Southlake, TX 76092
Phone (682) 212-9104

Interoperability endpoints

  • Direct secure messaging: prisca.johnogam.p11@direct.nextcare.nextgenshare.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1587945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1093336315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4136 BILLY MITCHELL DR",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750014350",
            "telephone_number": "347-684-6498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 HUNTINGTON AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155005",
            "telephone_number": "347-684-6498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN-OGAM",
        "first_name": "PRISCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-27",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.