Individual provider Active NPI

Millicent G Osorio, MD

  • Internal Medicine Physician
  • Cleveland, OH
National Provider Identifier
1538370705
Registry record updated Nov 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301083392 Issued in MI
Practice address
10701 East Blvd
Cleveland, OH 44106-1702
Phone
(419) 334-8943
Fax
(419) 334-8619
NPI assigned
May 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301083392 MI Primary
Internal Medicine Physician 207R00000X 35.089410 OH

Addresses

Primary practice location

10701 East Blvd
Cleveland, OH 44106-1702

Mailing address

10701 East Blvd
Cleveland, OH 44106-1702
Phone (419) 334-8943

Other identifiers 1

IdentifierTypeStateIssuer
2771782MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20161123001683 OH Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 1355442898

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301083392MIMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1180137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479081600000",
    "number": "1538370705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10701 EAST BLVD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061702",
            "telephone_number": "419-334-8943",
            "fax_number": "419-334-8619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10701 EAST BLVD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061702",
            "telephone_number": "419-334-8943",
            "fax_number": "419-334-8619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSORIO",
        "first_name": "MILLICENT",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-26",
        "last_updated": "2016-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301083392",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.089410",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2771782",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.