Individual provider Active NPI

Ibiene Adonye Osuobeni, MD

  • Hospitalist Physician
  • Newark, OH
National Provider Identifier
1215197165
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
35.095111 Issued in OH
Practice address
1320 W Main St
Newark, OH 43055-1822
Phone
(220) 564-1791
NPI assigned
Jun 13, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 35.095111 OH Primary
Internal Medicine Physician 207R00000X 57013742 OH

Addresses

Primary practice location

1320 W Main St
Newark, OH 43055-1822

Mailing address

1320 W Main St
Newark, OH 43055-1822
Phone (220) 564-1791

Other practice location 1

3525 Olentangy River Rd
Suite 4330
Columbus, OH 43214-3937
Phone (614) 255-6900

Other practice location 2

401 Matthew St
Marietta, OH 45750-1635
Phone (740) 374-7700

Other practice location 3

1106 Colegate Dr
Marietta, OH 45750-1323
Phone (740) 374-7700

Other identifiers 1

IdentifierTypeStateIssuer
3084657MedicaidOH

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address ibiene.osuobeni@mmhs.medicity.net
Direct Messaging Address iosuobeni17860@lickingmemorial.medicity.net
Direct Messaging Address ibiene.osuobeni@mmhs.medicity.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20100624000496 OH Practitioner - Internal Medicine 2365573086 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

Practice addresses (Care Compare)

1320 W Main St
Newark, OH 43055-1822
Phone (220) 564-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.98 of 100Reported as group
Quality
75.66
Promoting interoperability
100
Improvement activities
40
Cost
75.38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57013742OHMDInternal Medicine Physician
35.095111OHMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Licking Memorial Professional Corporation CurrentSince Jan 15, 2021 Accepting new patients
Licking Memorial Health Professionals Hospitalist Current Accepting new patients
Central Ohio Hospitalists, Inc CurrentSince Aug 22, 2010 Accepting new patients
Licking Memorial Professional Corporation CurrentSince Jan 15, 2021 Accepting new patients
Licking Memorial Professional Corp. Past Accepting new patients

Locations

3535 Olentangy River Rd
Columbus, OH 43214
Phone (614) 566-1997

3525 Olentangy River Rd
Ste 4330
Columbus, OH 43214
Phone (614) 255-6930

5151 N Hamilton Rd
Gahanna, OH 43230
Phone (614) 337-1066

401 Matthew St
Marietta, OH 45750
Phone (740) 374-1400

120 McMillen Dr
Newark, OH 43055
Phone (220) 564-4806

1320 W Main St
Newark, OH 43055
Phone (740) 348-4151

1320 W Main St
Ste Er
Newark, OH 43055
Phone (740) 348-4598

Organizations & group practices 5

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 1

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": "1213315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1215197165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 W MAIN ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551822",
            "telephone_number": "220-564-1791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 W MAIN ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551822",
            "telephone_number": "220-564-1791"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3525 Olentangy River Rd",
            "address_2": "Suite 4330",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432143937",
            "country_code": "US",
            "telephone_number": "614-255-6900",
            "fax_number": "614-255-6901",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 Matthew St",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "OH",
            "postal_code": "457501635",
            "country_code": "US",
            "telephone_number": "740-374-7700",
            "fax_number": "740-374-7701",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1106 Colegate Dr",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "OH",
            "postal_code": "457501323",
            "country_code": "US",
            "telephone_number": "740-374-7700",
            "fax_number": "740-374-7701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OSUOBENI",
        "first_name": "IBIENE",
        "middle_name": "ADONYE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-13",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "35.095111",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "57013742",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3084657",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ibiene.osuobeni@mmhs.medicity.net",
            "affiliation": "N",
            "address_1": "1106 Colegate Dr",
            "city": "Marietta",
            "state": "OH",
            "country_code": "US",
            "postal_code": "457501323",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "iosuobeni17860@lickingmemorial.medicity.net",
            "affiliation": "N",
            "address_1": "1320 W Main St",
            "city": "Newark",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430551822",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ibiene.osuobeni@mmhs.medicity.net",
            "affiliation": "N",
            "address_1": "401 Matthew St",
            "city": "Marietta",
            "state": "OH",
            "country_code": "US",
            "postal_code": "457501635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

Verify at the official NPI Registry.