Ergo Occmed LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

19226 Issued in MD

Legal business name

ERGO OCCMED LLC

Practice address

6196 Oxon Hill Rd
Suite 120
Oxon Hill, MD 20745-3100

Phone

(301) 567-6400

Fax

(202) 318-8174

NPI assigned

Sep 22, 2009

Organization subpart

Yes

Parent organization

ERGO OCCMED LLCAs reported in NPPES

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

Authorized official

Name

Olu Peter EzeaniNPI 1699711598

Title

Owner/Provider

Phone

(301) 567-6400

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Part of

Ergo Occmed LLC

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Olu Peter Ezeani, DPT

  • Physical Therapist
  • Oxon Hill, MD
  • NPI 1699711598

  DC

  Medicare reassignment Care Compare group NPD Authorized official
• Jason Henderson, DPT

  • Physical Therapist
  • Oxon Hill, MD
  • NPI 1881630556

  DC

  Medicare reassignment Care Compare group NPD
• Jeffrey W Wright, PT

  • Physical Therapist
  • Ft Washington, MD
  • NPI 1275737512

  DC

  Medicare reassignment Care Compare group NPD
• Ada Cecelia Ezeani, MS, OTR/L

  • Occupational Therapist
  • Beltsville, MD
  • NPI 1679970602

  DC

  Medicare reassignment NPD
• Denise Moore Revel, MS

  • Speech-Language Pathologist
  • Greenbelt, MD
  • NPI 1013231364

  DC

  Medicare reassignment

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

{
    "created_epoch": "1253577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773014400000",
    "number": "1720312903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6196 OXON HILL RD STE 120",
            "city": "OXON HILL",
            "state": "MD",
            "postal_code": "207453138",
            "telephone_number": "301-567-6400",
            "fax_number": "202-318-8174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6196 OXON HILL RD",
            "address_2": "SUITE 120",
            "city": "OXON HILL",
            "state": "MD",
            "postal_code": "207453100",
            "telephone_number": "301-567-6400",
            "fax_number": "202-318-8174"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1160 Varnum St NE Ste 300",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200172103",
            "country_code": "US",
            "telephone_number": "202-269-6400 x96400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ERGO OCCMED LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ERGO OCCMED LLC",
        "enumeration_date": "2009-09-22",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A",
        "authorized_official_last_name": "EZEANI",
        "authorized_official_first_name": "OLU",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "301-567-6400"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "DC",
            "license": "PT870468",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "19226",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "052848800",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420375500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Efemwonyi F Jesuorobo
• Efemwonyi F Jesuorobo
• Kenneth Embrack, PT
• Envue Eye & Laser Center LLC
• Envue Surgical LLC
• Eric G. Dawson, M.D., PC
• Obehi Esene, PHARM. D
• Kevin Espinoza
• Olu Peter Ezeani, DPT
• Abdul Hamid Fadul, M.D.

• Physical Therapist in Oxon Hill, MD
• Providers in Oxon Hill, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.