Omodele Ibitola Hogan, M.D.

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

MD465107 Issued in PA

Practice address

100 N Academy Ave
Danville, PA 17822-5301

Phone

(570) 271-6028

Fax

(570) 271-5845

NPI assigned

May 20, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ, PA2 enrollments

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 2

Specialty

Endocrinology

Education

University of South Florida College of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Clinical Health Care Associates of New Jersey PCGroup PAC ID 0749180198, 793 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University Medical Center of Princeton at Plainsboro Hospital, Plainsboro, NJ, CCN 310010

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Clinical Health Care Associates of New Jersey, P.C.

  • Family Medicine Physician
  • Cherry Hill, NJ
  • NPI 1447260435

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Geisinger Clinic

  • Family Medicine Physician
  • Danville, PA
  • NPI 1366493868
  Medicare reassignment NPD
• Geisinger Clinic

  • Diagnostic Radiology Physician
  • Danville, PA
  • NPI 1558313023

  NJ

  Medicare reassignment NPD
• Clinical Health Care Associates of New Jersey, PC

  • Obstetrics & Gynecology Nurse Practitioner
  • Langhorne, PA
  • NPI 1538728357
  NPD
• Geisinger Clinic

  • Surgery Physician
  • Danville, PA
  • NPI 1255382784
  NPD
• Geisinger Clinic

  • Pediatrics Physician
  • Scranton, PA
  • NPI 1952995482
  NPD
• Hospital Authority of the City of Bainbridge and Decatur County

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)

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

• Princeton Healthcare System, a New Jersey Non-Profit Corporation

  • General Acute Care Hospital
  • Plainsboro, NJ
  • NPI 1689714255
  Care Compare affiliation

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

{
    "created_epoch": "1242777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1093940918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 PLAINSBORO RD STE 300",
            "city": "PLAINSBORO",
            "state": "NJ",
            "postal_code": "085361915",
            "telephone_number": "609-853-7272",
            "fax_number": "609-853-7245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178225301",
            "telephone_number": "570-271-6028",
            "fax_number": "570-271-5845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "OMODELE",
        "middle_name": "IBITOLA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-20",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "13694",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NJ",
            "license": "25MA11280500",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "ME119257",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "PA",
            "license": "MD465107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013079700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zachary Scott Hoffer, MD., PH.D.
• Kerrie L Hoffman, OTR/L, MD
• Rebecca Lynn Hoffman, MD
• Ryan A. Hoffman, MD
• Stuart Hoffman, D.O.
• Benjamin A Hohmuth, M.D.
• Krystal Anne Holbert, PA-C
• Holding Space Therapy, LLC
• Kristy Denise Holecko, M.D.
• Archie Holsomback III, RN

• Endocrinology, Diabetes & Metabolism Physician in Danville, PA
• Providers in Danville, PA by specialty
• Endocrinology, Diabetes & Metabolism Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.