Individual provider Active NPI

Paul Youngbok Oh, MD

  • Gastroenterology Physician
  • Gastonia, NC
National Provider Identifier
1689633794
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
2010-00244 Issued in NC
Practice address
2544 Court Dr Ste G
Gastonia, NC 28054-3450
Phone
(704) 854-9990
Fax
(704) 854-9045
NPI assigned
Mar 20, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 01054173A IN
Gastroenterology Physician 207RG0100X 2010-00244 NC Primary

Addresses

Primary practice location

2544 Court Dr Ste G
Gastonia, NC 28054-3450

Mailing address

2544 Court Dr Ste G
Gastonia, NC 28054-3450
Phone (704) 854-9990

Other practice location 1

1234 Huffman Mill Rd
Burlington, NC 27215-8700
Phone (336) 538-1234

Other identifiers 6

IdentifierTypeStateIssuer
10825690OtherINCAQH NUMBER
000000202136OtherINANTHEM PROVIDER NUMBER
1689633794MedicaidNC
200340710MedicaidIN
510421OtherINPHCS PID NUMBER
159C4OtherNCBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20100727000892 NC Practitioner - Gastroenterology 4183767130 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Pennsylvania State University College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wakemed Specialists Group LLCGroup PAC ID 2466788377, 868 clinicians

Practice addresses (Care Compare)

110 Kildaire Park Dr
Cary, NC 27518-8161
Phone (919) 859-1136

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy33
Upper gastrointestinal (GI) endoscopy for acid reflux73

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2010-00244NCMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wakemed Specialists Group LLC CurrentSince Oct 24, 2022 Accepting new patients
Caromont Medical Group Inc Gastroenterology Current Accepting new patients
Wakemed Specialists Group, LLC Gastroenterology CurrentSince Oct 24, 2022 Accepting new patients
Caromont Medical Group Inc Gastroenterology CurrentSince Jun 12, 2017 Accepting new patients
Wakemed Specialists Group, LLC Gastroenterology Current Accepting new patients
Caromont Medical Group Inc CurrentSince Jun 12, 2017 Accepting new patients

Locations

110 Kildaire Park Dr
Cary, NC 27518
Phone (919) 235-0616

2544 Court Dr
Ste G
Gastonia, NC 28054
Phone (704) 854-9990

660 Summit Crossing Pl
Ste 301
Gastonia, NC 28054
Phone (704) 854-8799

10010 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1380

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

3024 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-5318

Interoperability endpoints

  • Direct secure messaging: poh429890@directhisp.wakemed.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1689633794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2544 COURT DR STE G",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280543450",
            "telephone_number": "704-854-9990",
            "fax_number": "704-854-9045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2544 COURT DR STE G",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280543450",
            "telephone_number": "704-854-9990",
            "fax_number": "704-854-9045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1234 Huffman Mill Rd",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "NC",
            "postal_code": "272158700",
            "country_code": "US",
            "telephone_number": "336-538-1234",
            "fax_number": "336-538-2390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OH",
        "first_name": "PAUL",
        "middle_name": "YOUNGBOK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IN",
            "license": "01054173A",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "2010-00244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH NUMBER",
            "identifier": "10825690",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000202136",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689633794",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200340710",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS PID NUMBER",
            "identifier": "510421",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "159C4",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.