Japheth Eitamaegbe Okpebholo, DO

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

OS025067 Issued in PA

Practice address

1000 E Mountain Dr
Wilkes Barre, PA 18711-0027

Phone

(570) 808-6020

Fax

(570) 808-2306

NPI assigned

Apr 8, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Cardiovascular Disease (Cardiology)

Education

New York College of Osteo Medicine of New York Institute of Technology, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Geisinger Clinic

  • Clinic/Center
  • Moosic, PA
  • NPI 1346073640
  NPD
• Geisinger Clinic

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

  • Diagnostic Radiology Physician
  • Danville, PA
  • NPI 1558313023
  NPD
• Geisinger Clinic

  • Hospitalist Physician
  • Wilkes Barre, PA
  • NPI 1588614358
  NPD (past)

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

{
    "created_epoch": "1649376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1174265334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-808-6020",
            "fax_number": "570-808-2306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E MOUNTAIN DR",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187110027",
            "telephone_number": "570-808-6020",
            "fax_number": "570-808-2306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKPEBHOLO",
        "first_name": "JAPHETH",
        "middle_name": "EITAMAEGBE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-08",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "OS025067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shivaun Odonnell, RN
• Adesumbo Oladimeji Odunlami
• Seong Cheol Oh, M.D.
• Kaitlyn Ohl
• Charise M Okonski, COTA
• Amanda J Olaviany, LSW
• Ashley Oliva
• Adam Olivetti, PHARMD
• Sandra Kristine Olowiany, RRT
• Hans P. Olsen IV, M.D.

• All providers in Wilkes Barre, PA
• Cardiovascular Disease Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2025; 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.