NPIMap

Individual provider Active NPI

Marek Jaroslaw Ogledzki, MD, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Charleston, WV
National Provider Identifier
1508124363
Registry record updated Oct 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
4592 Issued in WV
Practice address
415 Morris St Ste 309
Charleston, WV 25301-1853
Phone
(304) 388-3290
NPI assigned
Apr 30, 2012
Last updated
Oct 2, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2022

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN20042 FL
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 31800 WV
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 2901600263 MI
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DN20042 FL
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 4592 WV Primary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X TRN23463 FL
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 4301116139 MI

Addresses

Primary practice location

415 Morris St Ste 309
Charleston, WV 25301-1853

Mailing address

415 Morris St Ste 309
Charleston, WV 25301-1853
Phone (304) 388-3290

Other practice location 1

2301 Park Ave Ste 101
Orange Park, FL 32073-5558
Phone (904) 269-5195

Other practice location 2

830 Pennsylvania Ave Ste 302
Charleston, WV 25302-3390
Phone (304) 388-2950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230207003383 WV Practitioner - Maxillofacial Surgery 1951622661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial Surgery
Education
University of Florida College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

415 Morris St
Suite 309
Charleston, WV 25301-1853
Phone (304) 388-3290

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2901600263MIMDOral and Maxillofacial Surgery (Dentist)
31800WVMDOral and Maxillofacial Surgery (Dentist)
4592WVMDOral and Maxillofacial Surgery (Dentist)
TRN23463FLMDOral & Maxillofacial Surgery (D.M.D.)

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center, Inc. CurrentSince Oct 27, 2022 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Oct 27, 2022 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients

Locations

415 Morris St
Ste 309
Charleston, WV 25301
Phone (304) 348-3290

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

830 Pennsylvania Ave
Ste 302
Charleston, WV 25302
Phone (304) 388-2950

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664668800000",
    "number": "1508124363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MORRIS ST STE 309",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011853",
            "telephone_number": "304-388-3290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MORRIS ST STE 309",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011853",
            "telephone_number": "304-388-3290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 Park Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Orange Park",
            "state": "FL",
            "postal_code": "320735558",
            "country_code": "US",
            "telephone_number": "904-269-5195",
            "fax_number": "904-269-7196",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "830 Pennsylvania Ave Ste 302",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253023390",
            "country_code": "US",
            "telephone_number": "304-388-2950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OGLEDZKI",
        "first_name": "MAREK",
        "middle_name": "JAROSLAW",
        "name_prefix": "Dr.",
        "credential": "MD,  DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-30",
        "last_updated": "2022-10-02",
        "certification_date": "2022-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN20042",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WV",
            "license": "31800",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "2901600263",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN20042",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WV",
            "license": "4592",
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "FL",
            "license": "TRN23463",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MI",
            "license": "4301116139",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.