Individual provider Active NPI

Douglas A Ockrymiek, DO

  • Psychiatry Physician
  • Lancaster, PA
National Provider Identifier
1194761015
Registry record updated Dec 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
OS004324L Issued in PA
Practice address
790 New Holland Ave
Lancaster, PA 17602-2137
Phone
(717) 390-0353
Fax
(717) 390-1812
NPI assigned
Jun 20, 2006
Last updated
Dec 15, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X OS004324L PA Primary
Geriatric Psychiatry Physician 2084P0805X OS004324L PA

Addresses

Primary practice location

790 New Holland Ave
Lancaster, PA 17602-2137

Mailing address

320 Highland Dr
Mountville, PA 17554-1232
Phone (717) 285-7121

Other identifiers 4

IdentifierTypeStateIssuer
115435OtherPAPA BLUE SHIELD
50052373OtherPACAPITAL BLUE CROSS
000957497MedicaidPA
2095770OtherPACIGNA BEHAV HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS004324LPAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ephrata Community Hospital Current Accepting new patients
Samaritan Counseling Center PastSince Feb 10, 2004 Accepting new patients
Wellspan Medical Group Past Accepting new patients

Locations

169 Martin Ave
Ephrata, PA 17522
Phone (717) 733-0311

Organizations & group practices 3

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323907200000",
    "number": "1194761015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 HIGHLAND DR",
            "city": "MOUNTVILLE",
            "state": "PA",
            "postal_code": "175541232",
            "telephone_number": "717-285-7121",
            "fax_number": "717-285-5302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 NEW HOLLAND AVE",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176022137",
            "telephone_number": "717-390-0353",
            "fax_number": "717-390-1812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OCKRYMIEK",
        "first_name": "DOUGLAS",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2011-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "OS004324L",
            "primary": true
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "PA",
            "license": "OS004324L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA BLUE SHIELD",
            "identifier": "115435",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50052373",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000957497",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAV HEALTH",
            "identifier": "2095770",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.