NPIMap

Individual provider Active NPI

Clinton Hezekiah Ogolo, MD

  • Internal Medicine Physician
  • Trenton, NJ
National Provider Identifier
1730219981
Registry record updated Jul 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA60771 Issued in NJ
Practice address
1457 Nottingham Way
Trenton, NJ 08609-1909
Phone
(609) 586-3828
Fax
(609) 586-9466
NPI assigned
Mar 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MA60771 NJ Primary

Addresses

Primary practice location

1457 Nottingham Way
Trenton, NJ 08609-1909

Mailing address

1457 Nottingham Way
Trenton, NJ 08609-1909
Phone (609) 586-3828

Other identifiers 12

IdentifierTypeStateIssuer
1022197OtherNJHORIZON NJ HEALTH
24400OtherNJAMERIGROUP
P1094258OtherNJOXFORD
00349315OtherNJPENNSYLVANIA BC BS
0037114001OtherNJAMERIHEALTH
15542OtherNJUNIVERSITY HEALTH PLAN
6077100OtherNJMANAGE CARE
0K1372OtherNJHEALTH NET
349315OtherNJKEYSTONE HEALTH PLAN EAST
6514901MedicaidNJ
893850OtherNJCIGNA
531742OtherAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140217000042 NJ Practitioner - Internal Medicine 3971538174 Practice locations: Trenton, NJ

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1457 Nottingham Way
Trenton, NJ 08609-1909
Phone (609) 586-3828

Hospital & facility affiliations

  • Robert Wood Johnson Visiting Nurses, Inc Home health agency, North Brunswick, NJ, CCN 317079
  • Mercer Care Home health agency, Bordentown, NJ, CCN 317062
  • Capital Health Regional Medical Center Hospital, Trenton, NJ, CCN 310092
  • Capital Health Medical Center - Hopewell Hospital, Pennington, NJ, CCN 310044
  • Robert Wood Johnson University Hospital at Hamilton Hospital, Hamilton, NJ, CCN 310110

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA60771NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Health System Inc Past Accepting new patients
Capital Health System, Inc. Past Accepting new patients
Robert Wood Johnson University Hospital at Hamilton Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/5bb47b8f-8587-42a0-80df-8d4eecf69db3/
  • Direct secure messaging: clinton.ogolo@nottinghammedassociates.ehi.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185321600000",
    "number": "1730219981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1457 NOTTINGHAM WAY",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086091909",
            "telephone_number": "609-586-3828",
            "fax_number": "609-586-9466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1457 NOTTINGHAM WAY",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086091909",
            "telephone_number": "609-586-3828",
            "fax_number": "609-586-9466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGOLO",
        "first_name": "CLINTON",
        "middle_name": "HEZEKIAH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA60771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH",
            "identifier": "1022197",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "24400",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P1094258",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENNSYLVANIA BC BS",
            "identifier": "00349315",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0037114001",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERSITY HEALTH PLAN",
            "identifier": "15542",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGE CARE",
            "identifier": "6077100",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "0K1372",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH PLAN EAST",
            "identifier": "349315",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6514901",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "893850",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "531742",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, NJ

Sources for this page

Verify at the official NPI Registry.