Individual provider Active NPI

Oyindamola Abimbola Omije, MD

  • Child & Adolescent Psychiatry Physician
  • Lebanon, PA
National Provider Identifier
1386806636
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
MD447848 Issued in PA
Practice address
283 S Butler Rd
Lebanon, PA 17042-8939
Phone
(717) 273-8871
Fax
(717) 270-2429
NPI assigned
Jun 27, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD447848 PA
Child & Adolescent Psychiatry Physician 2084P0804X MD447848 PA Primary

Addresses

Primary practice location

283 S Butler Rd
Lebanon, PA 17042-8939

Mailing address

601 Memory LN
York, PA 17402-2231
Phone (717) 851-1405

Other practice location 1

252 S 4th St
Lebanon, PA 17042-6111
Phone (717) 821-8017

Other practice location 2

169 Martin Ave
Ephrata, PA 17522-1734
Phone (717) 733-0311

Other practice location 3

1001 S George St
York, PA 17403-3676
Phone (717) 851-2304

Other practice location 4

147 Gettys St
Gettysburg, PA 17325-2534
Phone (717) 334-2121

Other practice location 5

112 N 7th St
Chambersburg, PA 17201-1720
Phone (717) 267-7771

Other practice location 6

501 E Main St
Waynesboro, PA 17268-2353
Phone (717) 765-4000

Other identifiers 2

IdentifierTypeStateIssuer
MD447848OtherPASTATE LICENSE
102872758MedicaidPA

Other names 1

  • Oyindamola Abimbola Amao Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20131118001046 PA Practitioner - Psychiatry 3870729072 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD447848PAMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Jul 30, 2023 Accepting new patients
Teladoc Health Medical Group, P.a. Psychiatry Current Accepting new patients
Wellspan Medical Group Current Accepting new patients
Philhaven CurrentSince Oct 18, 2022 Accepting new patients
Wellspan Medical Group CurrentSince Jul 30, 2023 Accepting new patients

Locations

112 N 7th St
Chambersburg, PA 17201
Phone (717) 217-4300

785 5th Ave
Ste 3
Chambersburg, PA 17201

169 Martin Ave
Ephrata, PA 17522
Phone (717) 733-0311

6375 Chambersburg Rd
Fayetteville, PA 17222
Phone (717) 352-2721

147 Gettys St
Gettysburg, PA 17325
Phone (717) 334-2121

2501 Oregon Pike
Ste 113
Lancaster, PA 17601
Phone (717) 735-1954

283 S Butler Rd
Lebanon, PA 17042

252 S 4th St
Lebanon, PA 17042
Phone (717) 270-7500

283 Butler Rd
Mount Gretna, PA 17064
Phone (800) 932-0359

501 E Main St
Waynesboro, PA 17268
Phone (717) 765-3400

1001 S George St
York, PA 17403
Phone (717) 812-7687

1600 S George St
York, PA 17403
Phone (717) 848-3615

601 Memory Ln
York, PA 17402
Phone (717) 851-6670

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

Interoperability endpoints

  • Direct secure messaging: oomije38893@wellspan.direct-ci.com
  • Direct secure messaging: oyindamolaomije@tdh.allscriptsdirect.net

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1386806636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MEMORY LN",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174022231",
            "telephone_number": "717-851-1405",
            "fax_number": "717-851-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "283 S BUTLER RD",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170428939",
            "telephone_number": "717-273-8871",
            "fax_number": "717-270-2429"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "252 S 4th St",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170426111",
            "country_code": "US",
            "telephone_number": "717-821-8017",
            "fax_number": "717-270-2401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "169 Martin Ave",
            "address_purpose": "LOCATION",
            "city": "Ephrata",
            "state": "PA",
            "postal_code": "175221734",
            "country_code": "US",
            "telephone_number": "717-733-0311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 S George St",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174033676",
            "country_code": "US",
            "telephone_number": "717-851-2304",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "147 Gettys St",
            "address_purpose": "LOCATION",
            "city": "Gettysburg",
            "state": "PA",
            "postal_code": "173252534",
            "country_code": "US",
            "telephone_number": "717-334-2121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "112 N 7th St",
            "address_purpose": "LOCATION",
            "city": "Chambersburg",
            "state": "PA",
            "postal_code": "172011720",
            "country_code": "US",
            "telephone_number": "717-267-7771",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 E Main St",
            "address_purpose": "LOCATION",
            "city": "Waynesboro",
            "state": "PA",
            "postal_code": "172682353",
            "country_code": "US",
            "telephone_number": "717-765-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OMIJE",
        "first_name": "OYINDAMOLA",
        "middle_name": "ABIMBOLA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-27",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD447848",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "MD447848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MD447848",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102872758",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OYINDAMOLA",
            "last_name": "AMAO",
            "middle_name": "ABIMBOLA",
            "credential": "M.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lebanon, PA

Sources for this page

Verify at the official NPI Registry.