Individual provider Active NPI

Obiageri Egeolu, MD

  • Family Medicine Physician
  • Roseburg, OR
National Provider Identifier
1114668449
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
210636 Issued in OR
Practice address
150 NE Kenneth Ford Dr
Roseburg, OR 97470-1042
Phone
(541) 672-9596
NPI assigned
Apr 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 210636 OR Primary

Addresses

Primary practice location

150 NE Kenneth Ford Dr
Roseburg, OR 97470-1042

Mailing address

150 NE Kenneth Ford Dr
Roseburg, OR 97470-1042

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251111003868 TX Practitioner - Family Practice 1456732049 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Medicine Services of TX, PLLCGroup PAC ID 3274998067, 376 clinicians

Practice addresses (Care Compare)

1139 E Sonterra Blvd
San Antonio, TX 78258-4347
Phone (210) 638-2000

Hospital & facility affiliations

  • Methodist Hospital Stone Oak Hospital, San Antonio, TX, CCN 670055
  • Methodist Hospital Hospital, San Antonio, TX, CCN 450388

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
210636ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Medicine Services of TX, PLLC CurrentSince Oct 20, 2025 Accepting new patients

Locations

12141 Richmond Ave
Houston, TX 77082
Phone (281) 558-3444

11100 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 770-7000

1139 E Sonterra Blvd
San Antonio, TX 78258
Phone (210) 638-2000

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1648771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1114668449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 NE KENNETH FORD DR",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974701042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 NE KENNETH FORD DR",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974701042",
            "telephone_number": "541-672-9596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGEOLU",
        "first_name": "OBIAGERI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-01",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "210636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

Verify at the official NPI Registry.