Individual provider Active NPI

Iheonu Usouwa Oriaku, MD

  • Physical Medicine & Rehabilitation Physician
  • Vero Beach, FL
National Provider Identifier
1164579827
Registry record updated Sep 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
ME79198 Issued in FL
Practice address
631 17TH Street
Vero Beach, FL 32960-5518
Phone
(772) 778-1603
Fax
(772) 231-8470
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X ME79198 FL Primary

Addresses

Primary practice location

631 17TH Street
Vero Beach, FL 32960-5518

Mailing address

P O Box 2692
Vero Beach, FL 32961-2692
Phone (772) 778-1603

Other identifiers 1

IdentifierTypeStateIssuer
259802700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20101123000314 FL Practitioner - Physical Medicine and RehabilitationPractitioner - Emergency MedicinePractitioner - Family Practice 8820284391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Emergency Medicine, Family Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

631 17TH St
Vero Beach, FL 32960-5518
Phone (772) 564-1769

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Indian River Rehabilitation Medicine Clinic P a Physical Medicine & Rehabilitation CurrentSince Aug 25, 2010 Accepting new patients
Florida Respiratory-St Lucie Inc PastSince Aug 25, 2010 Accepting new patients

Locations

631 17th St
Vero Beach, FL 32960
Phone (772) 564-1769

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285632000000",
    "number": "1164579827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 2692",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329612692",
            "telephone_number": "772-778-1603",
            "fax_number": "772-231-8470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 17TH STREET",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329605518",
            "telephone_number": "772-778-1603",
            "fax_number": "772-231-8470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORIAKU",
        "first_name": "IHEONU",
        "middle_name": "USOUWA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2010-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME79198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "259802700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.