Individual provider Active NPI

Nkechinye Pamela Omesiete, MD

  • Surgery Physician
  • Cooperstown, NY
National Provider Identifier
1720465495
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
326289 Issued in NY
Practice address
1 Atwell Rd
Cooperstown, NY 13326-1301
Phone
(607) 547-6300
NPI assigned
May 1, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME158441 FL
Colon & Rectal Surgery Physician 208C00000X ME155441 FL
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X 326289 NY Primary

Addresses

Primary practice location

1 Atwell Rd
Cooperstown, NY 13326-1301

Mailing address

8921 Maxwell PL
Philadelphia, PA 19152-1517
Phone (267) 439-6733

Other practice location 1

1501 N Campbell Ave
RM 4334
Tucson, AZ 85724-1517
Phone (520) 626-7747

Other names 1

  • Nkechinye Pamela Omesiete Adejare Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, AZ, NY3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20230810002028 WI Practitioner - General Surgery 5496000648 Reassigns benefits to 1 organization
I20240102001524 AZ Practitioner - General Surgery 5496000648 Reassigns benefits to 1 organization
I20240117003768 NY Practitioner - General Surgery 5496000648 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Medical College of Wisconsin, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Imogene Bassett HospitalGroup PAC ID 3779488325, 780 clinicians

Practice addresses (Care Compare)

1 Atwell Rd
Cooperstown, NY 13326-1301
Phone (607) 547-3480

Hospital & facility affiliations

  • Bassett Healthcare Hospital, Cooperstown, NY, CCN 330136
  • Aurelia Osborn Fox Memorial Hospital Hospital, Oneonta, NY, CCN 330085
  • Little Falls Hospital Hospital, Little Falls, NY, CCN 331311
  • Cobleskill Regional Hospital Hospital, Cobleskill, NY, CCN 331320

Merit-based Incentive Payment System (MIPS)

Final score
92.62 of 100Reported as apm
Quality
77.97
Promoting interoperability
98
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
92.62 of 100Reported as apm
Quality
77.97
Promoting interoperability
98
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy76
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME158441FLMDSurgery Physician
326289NYMDSurgery Physician
ME155441FLMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health, LLC CurrentSince Dec 15, 2023 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Jan 2, 2024 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Jan 2, 2024 Accepting new patients
Brookview Medical Associates, PLLC CurrentSince Apr 7, 2024 Accepting new patients
The Univeristy of Arizona Past Accepting new patients
Mary Imogene Bassett Hospital Past Accepting new patients

Locations

2705 S Alma School Rd
Chandler, AZ 85286
Phone (480) 820-7246

80 Orville Dr
Ste 100
Bohemia, NY 11716
Phone (516) 308-6610

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

460 Andes Rd
Delhi, NY 13753
Phone (607) 746-0300

140 Burwell St
Little Falls, NY 13365
Phone (315) 823-1000

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 10

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.

Hospital & facility affiliations 5

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": "1430438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1720465495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8921 MAXWELL PL",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191521517",
            "telephone_number": "267-439-6733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ATWELL RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133261301",
            "telephone_number": "607-547-6300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 N Campbell Ave",
            "address_2": "RM 4334",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857241517",
            "country_code": "US",
            "telephone_number": "520-626-7747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OMESIETE",
        "first_name": "NKECHINYE",
        "middle_name": "PAMELA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-01",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME158441",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "FL",
            "license": "ME155441",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "326289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NKECHINYE",
            "last_name": "OMESIETE ADEJARE",
            "middle_name": "PAMELA",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cooperstown, NY

Sources for this page

Verify at the official NPI Registry.