NPIMap

Individual provider Active NPI

Samuel K. Owusu, M.D.

  • Obstetrics & Gynecology Physician
  • Port Matilda, PA
National Provider Identifier
1619930484
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD073242L Issued in PA
Practice address
132 Abigail LN
Port Matilda, PA 16870-7153
Phone
(814) 272-7100
Fax
(814) 272-6501
NPI assigned
Apr 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD073242L PA Primary

Addresses

Primary practice location

132 Abigail LN
Port Matilda, PA 16870-7153

Mailing address

100 N Academy Ave
Danville, PA 17822-3034
Phone (570) 271-6144

Other identifiers 1

IdentifierTypeStateIssuer
001851376MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sowusu75620@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20040226000245 PA Practitioner - Obstetrics/Gynecology 3173419181 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

132 Abigail LN
Port Matilda, PA 16870-7153
Phone (814) 272-7100

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Oct 29, 2019 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic Past Accepting new patients
Geisinger Clinic Selinsgrove Past Accepting new patients
Mount Nittany Medical Center Past Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

425 E 1st St
Ste 101
Bloomsburg, PA 17815
Phone (570) 387-2372

100 N Academy Ave
Danville, PA 17822

132 Abigail Ln
Port Matilda, PA 16870
Phone (814) 272-5011

10 Trieble Dr
Tunkhannock, PA 18657
Phone (570) 836-2273

Interoperability endpoints

  • Direct secure messaging: sowusu75620@direct.geisinger.edu

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.

Hospital & facility affiliations 40

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

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1619930484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178223034",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 ABIGAIL LN",
            "city": "PORT MATILDA",
            "state": "PA",
            "postal_code": "168707153",
            "telephone_number": "814-272-7100",
            "fax_number": "814-272-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWUSU",
        "first_name": "SAMUEL",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MD073242L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001851376",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sowusu75620@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "132 Abigail Ln",
            "city": "Port Matilda",
            "state": "PA",
            "country_code": "US",
            "postal_code": "168707153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Port Matilda, PA

Sources for this page

Verify at the official NPI Registry.