Charles Ogunro, M.D.

Primary specialty

Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X

License

MD036291L Issued in PA

Practice address

145 Hospital Ave
Suite 211
Du Bois, PA 15801-1462

Phone

(814) 375-2070

Fax

(814) 375-2076

NPI assigned

Nov 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Pinnacle Health Medical Services

  • Family Medicine Physician
  • Harrisburg, PA
  • NPI 1932143427
  Medicare reassignment NPD
• Pinnacle Health Medical Services

  • Infectious Disease Physician
  • Harrisburg, PA
  • NPI 1134327760
  NPD
• Pinnacle Health Medical Services

  • Gastroenterology Physician
  • Mechanicsburg, PA
  • NPI 1295552073
  NPD

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474329600000",
    "number": "1710058730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 HOSPITAL AVE",
            "address_2": "SUITE 211",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011462",
            "telephone_number": "814-375-2070",
            "fax_number": "814-375-2076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 HOSPITAL AVE",
            "address_2": "SUITE 211",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011462",
            "telephone_number": "814-375-2070",
            "fax_number": "814-375-2076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUNRO",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2016-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "NM",
            "license": "95-118",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "KY",
            "license": "49598",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "PA",
            "license": "MD036291L",
            "primary": true
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "KY",
            "license": "TP318",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00237590",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100413180",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010358330005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Sylvester O'Shea, M.D.
• Elayna June Oaks, CRNP
• Obryon Eye Associates LLC
• Obryon Family Medicine Inc
• Jacob Ogden
• Kenneth Anthony Omecinski
• Ozlem Onal, MD
• Oncology Hematology Associates of Northern PA, PC
• Oncology Hematology Associates of Northern PA, PC
• Diana Opalisky

• Clinical Neurophysiology Physician in Du Bois, PA
• Providers in Du Bois, PA by specialty
• Clinical Neurophysiology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.