Individual provider Active NPI

Hamilton Osasere Emokpae, M.D.

  • Internal Medicine Physician
  • Statesboro, GA
National Provider Identifier
1215013354
Registry record updated Jul 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
068726 Issued in GA
Practice address
1207 Merchant Way Ste 201B
Statesboro, GA 30458-0862
Phone
(912) 243-9080
Fax
(912) 243-9084
NPI assigned
Oct 31, 2006
Last updated
Jul 29, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 214695 NY
Internal Medicine Physician 207R00000X 068726 GA Primary

Addresses

Primary practice location

1207 Merchant Way Ste 201B
Statesboro, GA 30458-0862

Mailing address

PO Box 2380
Statesboro, GA 30459-2380
Phone (912) 243-9080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20130709000590 GA Practitioner - Internal Medicine 3971688797 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cogent Healthcare of Georgia PCGroup PAC ID 2961483607, 252 clinicians

Practice addresses (Care Compare)

1170 Cleveland Ave
East Point, GA 30344-3615
Phone (404) 466-1170

1207 Merchant Way
Suite 201
Statesboro, GA 30458-0862
Phone (912) 243-9080

4700 Waters Ave
Savannah, GA 31404-6220
Phone (912) 350-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
068726GAMDInternal Medicine Physician
214695NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Healthcare of Georgia PC Internal Medicine CurrentSince Mar 1, 2024 Accepting new patients
Supreme Internal Medicine, P.C. CurrentSince May 28, 2013 Accepting new patients
East Georgia Regional Medical Center, LLC Past Accepting new patients
Supreme Internal Medicine Internal Medicine PastSince Jun 1, 2013 Accepting new patients

Locations

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

1207 Merchant Way
#201B
Statesboro, GA 30458
Phone (912) 243-9080

1207 Merchant Way
Ste 201
Statesboro, GA 30458
Phone (912) 243-9080

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HFCCCA/Endpoint/HFCCCA

Organizations & group practices 4

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.

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": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375056000000",
    "number": "1215013354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2380",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304592380",
            "telephone_number": "912-243-9080",
            "fax_number": "912-243-9084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 MERCHANT WAY STE 201B",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580862",
            "telephone_number": "912-243-9080",
            "fax_number": "912-243-9084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMOKPAE",
        "first_name": "HAMILTON",
        "middle_name": "OSASERE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2013-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "214695",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "068726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

Verify at the official NPI Registry.