Active NPI
Larry M Ojeda, MD
- Urology Physician
- Beloit, WI
National Provider Identifier
1265541999
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 28270
- Practice address
- 1905 E. Huebbe Parkway
Beloit Health System Inc.
Beloit, WI 53511-1842 - Phone
- (608) 364-2200
- Fax
- (608) 364-2705
- NPI assigned
- Aug 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 28270 | WI | Primary |
| Urology Physician | 208800000X | 036-057903 | IL |
Addresses
Primary practice location
1905 E. Huebbe Parkway
Beloit Health System Inc.
Beloit, WI 53511-1842
Mailing address
1905 E. Huebbe Parkway
Beloit Health System Inc.
Beloit, WI 53511-1842
Phone (608) 364-2200
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10655 | Other | DEAN HEALTH PLAN | |
| 1265541999 | Medicaid | WI |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-057903 | IL | MD | Urology Physician |
| 28270 | WI | MD | Urology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318982400000",
"number": "1265541999",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1905 E. HUEBBE PARKWAY",
"address_2": "BELOIT HEALTH SYSTEM INC.",
"city": "BELOIT",
"state": "WI",
"postal_code": "535111842",
"telephone_number": "608-364-2200",
"fax_number": "608-364-2705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1905 E. HUEBBE PARKWAY",
"address_2": "BELOIT HEALTH SYSTEM INC.",
"city": "BELOIT",
"state": "WI",
"postal_code": "535111842",
"telephone_number": "608-364-2200",
"fax_number": "608-364-2705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OJEDA",
"first_name": "LARRY",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-29",
"last_updated": "2011-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "WI",
"license": "28270",
"primary": true
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "IL",
"license": "036-057903",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEAN HEALTH PLAN",
"identifier": "10655",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1265541999",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beloit, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.