Individual provider Active NPI

Sophia A. Omoro, MD, PHD

  • Otolaryngology Physician
  • Lima, OH
National Provider Identifier
1336323609
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
35.129523 Issued in OH
Practice address
1005 Bellefontaine Ave Ste 125
Lima, OH 45804-2893
Phone
(419) 998-8244
Fax
(419) 998-8243
NPI assigned
Dec 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD.201447 LA
Otolaryngology Physician 207Y00000X MD201447 LA
Otolaryngology Physician 207Y00000X 35.129523 OH Primary

Addresses

Primary practice location

1005 Bellefontaine Ave Ste 125
Lima, OH 45804-2893

Mailing address

1001 Bellefontaine Ave
Lima, OH 45804-2800
Phone (419) 998-4575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, OH, MS3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20080822000274 LA Practitioner - Otolaryngology 9537234703 Reassigns benefits to 1 organization
I20170208002223 OH Practitioner - Otolaryngology 9537234703 Reassigns benefits to 1 organization
I20220622000540 MS Practitioner - Otolaryngology 9537234703 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Tulane University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Graham Hospital AssociationGroup PAC ID 2769375021, shared by 15 NPIs, 124 clinicians

Practice addresses (Care Compare)

180 S Main St
Canton, IL 61520-2608
Phone (309) 647-0201

2028 N Seminary St
Galesburg, IL 61401-4559
Phone (309) 647-0201

Hospital & facility affiliations

  • Graham Hospital Association Hospital, Canton, IL, CCN 140001
  • Graham Hospital Association Hospital, Canton, IL, CCN 141356
  • St Mary Medical Center Hospital, Galesburg, IL, CCN 140064

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.201447LAMDOtolaryngology Physician
MD201447LAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport CurrentSince May 10, 2022 Accepting new patients
Memorial Hospital at Gulfport CurrentSince May 10, 2022 Accepting new patients
Memorial Hospital at Gulfport Current Accepting new patients
Ochsner Clinic LLC CurrentSince Aug 1, 2008 Accepting new patients
Lima Memorial Professional Corporation CurrentSince Feb 13, 2017 Accepting new patients
Ochsner Clinic LLC Current Accepting new patients
Ochsner Clinic LLC CurrentSince Aug 1, 2008 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Graham Hospital Association Past Accepting new patients

Locations

1000 Ochsner Blvd
Covington, LA 70433
Phone (985) 898-7051

1514 Jefferson Hwy
New Orleans, LA 70121

104 Acadia Park Dr
Raceland, LA 70394
Phone (985) 537-3211

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

L3982
Columbus, OH 43260

1001 Bellefontaine Ave
Lima, OH 45804
Phone (419) 228-3335

1005 Bellefontaine Ave
Ste 125
Lima, OH 45804
Phone (419) 222-5160

1003 Bellefontaine Ave
Ste 125
Lima, OH 45804
Phone (419) 998-8207

Interoperability endpoints

  • Direct secure messaging: somoro@direct.mhg.com

Organizations & group practices 10

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 2

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": "1198195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1336323609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 BELLEFONTAINE AVE",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458042800",
            "telephone_number": "419-998-4575",
            "fax_number": "419-998-4586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 BELLEFONTAINE AVE STE 125",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458042893",
            "telephone_number": "419-998-8244",
            "fax_number": "419-998-8243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMORO",
        "first_name": "SOPHIA",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-21",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "LA",
            "license": "MD.201447",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "LA",
            "license": "MD201447",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OH",
            "license": "35.129523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

Verify at the official NPI Registry.