Individual provider Active NPI

Stanley E Okosun, MD

  • Surgery Physician
  • Lincoln, NE
National Provider Identifier
1316107444
Registry record updated May 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
25144 Issued in NE
Practice address
2300 S 16TH St
Lincoln, NE 68502-3704
Phone
(402) 328-8833
Fax
(402) 328-2921
NPI assigned
Jun 12, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 25144 NE Primary
Surgical Critical Care Physician 2086S0102X 25144 NE

Addresses

Primary practice location

2300 S 16TH St
Lincoln, NE 68502-3704

Mailing address

PO Box 67250
Lincoln, NE 68506-7250
Phone (402) 328-8833

Other identifiers 6

IdentifierTypeStateIssuer
200634870AMedicaidKS
P00739812OtherNERAILROAD MEDICARE
N/AMedicaidIA
47077696002MedicaidNE
10025037900MedicaidNE
13914OtherNEBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20210818004266 AZ Practitioner - General Surgery 4688726441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner-University Medical GroupGroup PAC ID 7719899871, 1,066 clinicians

Practice addresses (Care Compare)

3838 N Campbell Ave
BLDG 1
Tucson, AZ 85719-1454
Phone (520) 694-2873

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.34 of 100Reported as apm
Quality
74.56
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25144NEMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group Family Medicine CurrentSince Sep 13, 2021 Accepting new patients
Banner-University Medical Group CurrentSince Sep 13, 2021 Accepting new patients
Banner - University Medical Center South Campus LLC Past Accepting new patients
Banner - University Medical Center Tucson Campus LLC Past Accepting new patients

Locations

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

2800 E Ajo Way
Bldg 100
Tucson, AZ 85713
Phone (520) 419-5820

535 N Wilmot Rd
Ste 101
Tucson, AZ 85711
Phone (520) 694-9988

3838 N Campbell Ave
Bldg 1
Tucson, AZ 85719
Phone (520) 694-2873

1625 N Campbell Ave
Tucson, AZ 85719

3838 N Campbell Ave
Bldg 2
Tucson, AZ 85719

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 and National Provider Directory roles.

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": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274659200000",
    "number": "1316107444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67250",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685067250",
            "telephone_number": "402-328-8833",
            "fax_number": "402-328-2921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 S 16TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685023704",
            "telephone_number": "402-328-8833",
            "fax_number": "402-328-2921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKOSUN",
        "first_name": "STANLEY",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-12",
        "last_updated": "2010-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NE",
            "license": "25144",
            "primary": true
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NE",
            "license": "25144",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200634870A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00739812",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N/A",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47077696002",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025037900",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "13914",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.