Rebecca Oyetoro, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

LL92829 Issued in SC

Practice address

30 Courtenay Drive Suite BM 654, MSC 295
Charleston, SC 29425-0001

Phone

(843) 792-5976

NPI assigned

Jul 1, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1346085248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 COURTENAY DRIVE SUITE BM 654, MSC 295",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294250001",
            "telephone_number": "843-792-5976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 COURTENAY DRIVE SUITE BM 654, MSC 295",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294250001",
            "telephone_number": "843-792-5976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OYETORO",
        "first_name": "REBECCA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "SC",
            "license": "LL92829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Ann Overton, PA-C
• Stefanie Marie Owczarski, PA-C
• Charles Jerry Owens, MD
• Jack R Owens
• Tania Marie Owens, LISW
• Shelly D Ozark, MD
• Alison Jane Ozyurt
• Vanessa Tavares P Silvino
• Pace Health Services, Inc.
• Luz Elizabeth Pacheco, M.D.

• Vascular Surgery Physician in Charleston, SC
• Providers in Charleston, SC by specialty
• Vascular Surgery Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.