Individual provider Active NPI

Osaze Edo-Ohonba, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Columbia, MO
National Provider Identifier
1639331317
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
2018019491 Issued in MO
Practice address
1600 East Broadway
Columbia, MO 65201-5844
Phone
(573) 815-8000
NPI assigned
Jun 25, 2008
Last updated
Feb 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT 185563 PA
Internal Medicine Physician 207R00000X 2018019491 MO
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 2018019491 MO Primary
Pulmonary Disease Physician 207RP1001X 2018019491 MO
Hospitalist Physician 208M00000X 01065638A IN

Addresses

Primary practice location

1600 East Broadway
Columbia, MO 65201-5844

Mailing address

1600 E Broadway
Columbia, MO 65201-5844
Phone (573) 815-8000

Other identifiers 1

IdentifierTypeStateIssuer
200908800MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IN2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20180831000261 MO Practitioner - Critical Care (Intensivists) 7113094012 Reassigns benefits to 2 organizations
I20230621003439 IN Practitioner - Critical Care (Intensivists)Practitioner - Pulmonary Disease 7113094012 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Landmark Hospital of Joplin LLCGroup PAC ID 5698870822, 8 clinicians
Deaconess Hospital, Inc.Group PAC ID 9032021431, 410 clinicians
Landmark Hospital of Columbia LLCGroup PAC ID 2062568025, 8 clinicians

Practice addresses (Care Compare)

2040 W 32ND St
Joplin, MO 64804-3512
Phone (417) 627-1300

3255 Independence St
Cape Girardeau, MO 63701-4914

519 Harriet St
Evansville, IN 47710-1715
Phone (812) 450-7720

604 Old 63
Columbia, MO 65201-4557
Phone (573) 499-6632

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.17 of 100Reported as group
Quality
82.57
Promoting interoperability
100
Improvement activities
40
Cost
71.91

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2018019491MOMDInternal Medicine Physician
MT 185563PAMDInternal Medicine Physician
01065638AINMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Hospital, Inc Internal Medicine Current Accepting new patients
Deaconess Hospital Inc CurrentSince Jun 19, 2023 Accepting new patients
Landmark Hospital of Joplin, LLC CurrentSince Dec 10, 2021 Accepting new patients
Landmark Hospital of Columbia LLC CurrentSince Dec 10, 2021 Accepting new patients
Deaconess Hospital, Inc Critical Care Medicine CurrentSince Jun 19, 2023 Accepting new patients

Locations

4600 W Lloyd Expy
Evansville, IN 47712
Phone (812) 450-6311

519 Harriet St
Evansville, IN 47710
Phone (812) 423-9699

604 Old Highway 63 N
Columbia, MO 65201
Phone (573) 499-6600

3255 Independence St
Cpe Girardeau, MO 63701
Phone (573) 331-8026

2040 W 32nd St
Joplin, MO 64804
Phone (417) 627-1300

Interoperability endpoints

  • Direct secure messaging: oedoohonba237554@direct.deaconess.com
  • Direct secure messaging: osazeedoohonba@mhccaremail.com

Organizations & group practices 5

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 4

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": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1639331317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 E BROADWAY",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652015844",
            "telephone_number": "573-815-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 EAST BROADWAY",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652015844",
            "telephone_number": "573-815-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDO-OHONBA",
        "first_name": "OSAZE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-25",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT 185563",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2018019491",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MO",
            "license": "2018019491",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MO",
            "license": "2018019491",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01065638A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200908800",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.