Kemka S Ogburia Jr., MD

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

ME101561 Issued in FL

Practice address

515 W State Road 434
Suite 210
Longwood, FL 32750-4981

Phone

(407) 332-8080

Fax

(407) 260-0602

NPI assigned

Jan 27, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Dermatology

Education

University of South Alabama College of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oasis Dermatology, PLLCGroup PAC ID 5193075471, 4 clinicians

Dermatology Group PAGroup PAC ID 4385676782, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Waterman Hospital, Tavares, FL, CCN 100057

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Dermatology Group PA

  • Specialist
  • Mount Dora, FL
  • NPI 1356300081
  Medicare reassignment Care Compare group NPD
• Oasis Dermatology, PLLC

  • Dermatology Physician
  • Winter Park, FL
  • NPI 1912403742
  Medicare reassignment Care Compare group
• Jewett Orthopaedic Clinic LLC

  • Orthopaedic Surgery Physician
  • Winter Park, FL
  • NPI 1821097437
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Florida Hospital Waterman Inc

  dba AdventHealth Waterman

  • General Acute Care Hospital
  • Tavares, FL
  • NPI 1821019571
  Care Compare affiliation

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

{
    "created_epoch": "1201392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1275710758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 W STATE ROAD 434",
            "address_2": "SUITE 210",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504981",
            "telephone_number": "407-332-8080",
            "fax_number": "407-260-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 W STATE ROAD 434",
            "address_2": "SUITE 210",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504981",
            "telephone_number": "407-332-8080",
            "fax_number": "407-260-0602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGBURIA",
        "first_name": "KEMKA",
        "middle_name": "S",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-27",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME101561",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "IL",
            "license": "036118526",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "FL",
            "license": "ME101561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hector Octaviani, MD
• Ruby Odamtten, PMHNP-BC
• Dorothy Jean Odom, M.D.
• Mark Steven Offenback, DDS PA
• Ricardo Emilio Ogando Deleon, MD
• Ailin Ojeda Rodriguez, APRN, RN
• Corliss Yvette Oliver, M.D.
• Erika G. Oliver, ARNP
• Kayla E Oliver, M.A.
• Patricia Olsak Loch, CNA

• MOHS-Micrographic Surgery Physician in Longwood, FL
• Providers in Longwood, FL by specialty
• MOHS-Micrographic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; 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.