Individual provider Active NPI

George C Ego-Osuala, MD., FACP

  • General Practice Physician
  • Takoma Park, MD
National Provider Identifier
1679578835
Registry record updated May 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
D 47156 Issued in MD
Practice address
7676 New Hampshire Ave
Ste 420
Takoma Park, MD 20912-7516
Phone
(301) 434-9147
Fax
(301) 434-9178
NPI assigned
Jun 15, 2005
Last updated
May 13, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2008

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D 47156 MD
Internal Medicine Physician 207R00000X MD 21355 DC
General Practice Physician 208D00000X D 47156 MD Primary
General Practice Physician 208D00000X MD 21355 DC

Addresses

Primary practice location

7676 New Hampshire Ave
Ste 420
Takoma Park, MD 20912-7516

Mailing address

PO Box 7909
Hyattsville, MD 20787-7909
Phone (301) 434-9147

Other identifiers 2

IdentifierTypeStateIssuer
852000300MedicaidMD
0490330MedicaidDC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20080630000423 DC Practitioner - Internal MedicinePractitioner - General Practice 5799857199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: General Practice
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sun Rise Rehab LLCGroup PAC ID 4880783810, 22 clinicians

Practice addresses (Care Compare)

7249 Hanover Pkwy
Suite a
Greenbelt, MD 20770-3608
Phone (301) 613-8923

9311 Annapolis Rd
Lanham, MD 20706-3103
Phone (301) 277-7141

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 21355DCMDInternal Medicine Physician
D 47156MDMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210636800000",
    "number": "1679578835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7909",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207877909",
            "telephone_number": "301-434-9147",
            "fax_number": "301-434-9178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7676 NEW HAMPSHIRE AVE",
            "address_2": "STE 420",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "209127516",
            "telephone_number": "301-434-9147",
            "fax_number": "301-434-9178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGO-OSUALA",
        "first_name": "GEORGE",
        "middle_name": "C",
        "credential": "MD., FACP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2008-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D 47156",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DC",
            "license": "MD 21355",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MD",
            "license": "D 47156",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "DC",
            "license": "MD 21355",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "852000300",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0490330",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Takoma Park, MD

Sources for this page

Verify at the official NPI Registry.