Individual provider Active NPI

Osawaru Jude Omoruyi, M.D

  • Family Medicine Physician
  • Louisville, KY
National Provider Identifier
1396961967
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
42023 Issued in KY
Practice address
2202 Buechel Ave Ste 103
Louisville, KY 40218-2672
Phone
(502) 456-0494
Fax
(502) 456-0496
NPI assigned
Apr 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 42023 KY Primary
Family Medicine Physician 207Q00000X 35.088666 OH
Geriatric Medicine (Family Medicine) Physician 207QG0300X 01066757A IN

Addresses

Primary practice location

2202 Buechel Ave Ste 103
Louisville, KY 40218-2672

Mailing address

2202 Buechel Ave
Ste 105
Louisville, KY 40218-2672
Phone (502) 456-0494

Other identifiers 2

IdentifierTypeStateIssuer
2009500930MedicaidIN
7100072730MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY, IN, FL4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20070822000758 OH Practitioner - Family Practice 8921190992 Reassigns benefits to 1 organization
I20090325000174 KY Practitioner - Family PracticePractitioner - Geriatric Medicine 8921190992 Reassigns benefits to 4 organizations
I20090728000749 IN Practitioner - Geriatric MedicinePractitioner - Family PracticePractitioner - Emergency Medicine 8921190992 Reassigns benefits to 1 organization
I20220115000118 FL Practitioner - Family Practice 8921190992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pearl Medical Practice, PLLCGroup PAC ID 1951547108, 2 clinicians
Pearl Geriatrics and Palliative Medicine, PSCGroup PAC ID 6103954847, 6 clinicians

Practice addresses (Care Compare)

2202 Buechel Ave
Louisville, KY 40218-2672
Phone (502) 456-0494

5757 Lynx CT
Mason, OH 45040-8002
Phone (502) 456-0494

67 San Roy Rd
Santa Rosa Beach, FL 32459-6751
Phone (502) 456-0494

Hospital & facility affiliations

  • Hosparus, Inc Hospice, Louisville, KY, CCN 181502
  • Baptist Health Lagrange Hospital, La Grange, KY, CCN 180138
  • Norton Hospitals, Inc Hospital, Louisville, KY, CCN 180088
  • UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Hospital, Louisville, KY, CCN 180040
  • Essex Rehabilitation and Healthcare Center Nursing home, Louisville, KY, CCN 185288
  • Louisville East Post Acute Nursing home, Louisville, KY, CCN 185178
  • Richwood Nursing & Rehab Nursing home, La Grange, KY, CCN 185438
  • New Castle Nursing & Rehab Nursing home, New Castle, KY, CCN 185362
  • Wesley Manor Nursing home, Louisville, KY, CCN 185136

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.088666OHMDFamily Medicine Physician
01066757AINMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Nov 1, 2019 Accepting new patients
Telos Health Systems Ky LLC CurrentSince Jan 28, 2020 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Nov 1, 2019 Accepting new patients
University of Louisville Physicians, Inc. Family Medicine Current Accepting new patients
Pearl Geriatrics and Palliative Medicine, PSC Geriatric Medicine CurrentSince Feb 28, 2010 Accepting new patients
Pearl Diagnostic Laboratory, LLC CurrentSince May 20, 2022 Accepting new patients
Spring Medical Center PLLC Geriatric Medicine Current Accepting new patients
Richwoodidence Opco, LLC Past Accepting new patients
Pearl Medical Practice PLLC Past Accepting new patients
Jeffersontown Opco, LLC Past Accepting new patients
Regency Health Center LLC Past Accepting new patients
Gallatinidence Opco, LLC Past Accepting new patients
Breckinridge Health, Inc. Past Accepting new patients
New Castleidence Opco, LLC Past Accepting new patients
Hanging Rock LTC, LLC Past Accepting new patients
Wesley Manor Retirement Community Inc. Past Accepting new patients
Bradford Square Health Center LLC Past Accepting new patients
Louisville East Post Acute, LLC Past Accepting new patients
Pearl Medical Practice PLLC PastSince Jan 31, 2021 Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

945 Wall St
Jeffersonville, IN 47130
Phone (812) 725-7187

1012 Richwood Way
Lagrange, KY 40031
Phone (502) 222-3186

150 N Eagle Creek Dr
Lexington, KY 40509
Phone (859) 267-9773

201 Abraham Flexner Way
Ste 1200
Louisville, KY 40202
Phone (502) 583-8383

1550 Raydale Dr
Louisville, KY 40219
Phone (502) 968-6600

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

1850 Bluegrass Ave
Louisville, KY 40215
Phone (502) 361-6617

2202 Buechel Ave
Ste 105
Louisville, KY 40218
Phone 50245604944010

3500 Good Samaritan Way
Louisville, KY 40299
Phone (502) 267-7403

4200 Browns Ln
Louisville, KY 40220
Phone (502) 454-8460

5012 E Manslick Rd
Louisville, KY 40219
Phone (502) 969-3277

9600 Lamborne Blvd
Louisville, KY 40272
Phone (502) 935-7284

5100 Outer Loop
Louisville, KY 40219
Phone (502) 968-6226

50 Adams St
New Castle, KY 40050
Phone (502) 845-2861

Interoperability endpoints

  • Direct secure messaging: osawaru.omoruyi@pgapmp-ky.direct.office.nextgen.com
  • Direct secure messaging: oomoruyi@pmpp-ky.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Wesley Manor Retirement Community Inc.Louisville, KY, CCN 185136 Skilled nursing facility Adp of the SNF Aug 17, 2020
Gallatin Nursing & RehabWarsaw, KY, CCN 185360 Skilled nursing facility Contracted Managing Employee Jan 1, 2024
Richwood Nursing & RehabLa Grange, KY, CCN 185438 Skilled nursing facility Contracted Managing Employee May 1, 2018
Louisville East Post AcuteLouisville, KY, CCN 185178 Skilled nursing facility Contracted Managing Employee Apr 1, 2016
Essex Rehabilitation and Healthcare CenterLouisville, KY, CCN 185288 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Sep 4, 2025
Sep 4, 2025

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 20

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.

View all 20

Hospital & facility affiliations 44

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

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1396961967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 BUECHEL AVE",
            "address_2": "STE 105",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402182672",
            "telephone_number": "502-456-0494",
            "fax_number": "502-456-0496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 BUECHEL AVE STE 103",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402182672",
            "telephone_number": "502-456-0494",
            "fax_number": "502-456-0496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMORUYI",
        "first_name": "OSAWARU",
        "middle_name": "JUDE",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "42023",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.088666",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "IN",
            "license": "01066757A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2009500930",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100072730",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.