NPIMap

Organization Active NPI

Pecos T. Olurin MD, PA

  • Ophthalmology Physician
  • Wilmington, DE
National Provider Identifier
1518022235
Registry record updated Apr 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
C10005400 Issued in DE
Legal business name
PECOS T. OLURIN MD, PA
Practice address
1403 N Rodney St
Wilmington, DE 19806-4218
Phone
(302) 654-4800
Fax
(302) 984-0440
NPI assigned
Dec 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2008

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

Authorized official

Name
Dr. Temidayo A OlurinNPI 1093710691
Title
President
Phone
(302) 654-4800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X C10005400 DE
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X C10005400 DE Primary

Addresses

Primary practice location

1403 N Rodney St
Wilmington, DE 19806-4218

Mailing address

1403 N Rodney St
Wilmington, DE 19806-4218
Phone (302) 654-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120502000382 DE Part B Supplier - Clinic/Group Practice 1456513712 Receives reassigned benefits from 1 practitioner
Practice locations: Wilmington, DE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209081600000",
    "number": "1518022235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1403 N RODNEY ST",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198064218",
            "telephone_number": "302-654-4800",
            "fax_number": "302-984-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 N RODNEY ST",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198064218",
            "telephone_number": "302-654-4800",
            "fax_number": "302-984-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PECOS T. OLURIN MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-22",
        "last_updated": "2008-04-25",
        "status": "A",
        "authorized_official_last_name": "OLURIN",
        "authorized_official_first_name": "TEMIDAYO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "302-654-4800",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C10005400",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "DE",
            "license": "C10005400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.