NPIMap

Individual provider Active NPI

Cynthia Onon Okoduwa, M.D.

  • Diagnostic Radiology Physician
  • Bethlehem, PA
National Provider Identifier
1750518056
Registry record updated Jun 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD444557 Issued in PA
Practice address
95 Highland Ave Ste 130
Bethlehem, PA 18017
Phone
(610) 868-1100
Fax
(610) 868-1111
NPI assigned
Jun 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X 25MA09312500 NJ
Diagnostic Radiology Physician 2085R0202X MD444557 PA Primary

Addresses

Primary practice location

95 Highland Ave Ste 130
Bethlehem, PA 18017

Mailing address

95 Highland Ave Ste 130
Bethlehem, PA 18017-9483
Phone (610) 868-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120723000389 PA Practitioner - Diagnostic RadiologyPractitioner - Internal Medicine 4981860830 Reassigns benefits to 1 organization
I20140430000375 NJ Practitioner - Diagnostic RadiologyPractitioner - Internal Medicine 4981860830 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Internal Medicine
Education
Rutgers New Jersey Medical School, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Progressive Physician Assoc IncGroup PAC ID 1355243809, 164 clinicians

Practice addresses (Care Compare)

185 Roseberry St
Phillipsburg, NJ 08865-1690
Phone (908) 859-6700

95 Highland Ave
Suite 130
Bethlehem, PA 18017-9483
Phone (610) 868-1100

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Physician Assoc Inc Diagnostic Radiology CurrentSince Jun 1, 2018 Accepting new patients
Cogent Healthcare of Pennsylvania, Inc. Past Accepting new patients
Progressive Physician Assoc, Inc. Diagnostic Radiology PastSince Jun 1, 2018 Accepting new patients

Locations

185 Roseberry St
Phillipsburg, NJ 08865
Phone (908) 213-6611

95 Highland Ave
Ste 130
Bethlehem, PA 18017
Phone 61086811002

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

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 10

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": "1245024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528329600000",
    "number": "1750518056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 HIGHLAND AVE STE 130",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180179483",
            "telephone_number": "610-868-1100",
            "fax_number": "610-868-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 HIGHLAND AVE STE 130",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "18017",
            "telephone_number": "610-868-1100",
            "fax_number": "610-868-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKODUWA",
        "first_name": "CYNTHIA",
        "middle_name": "ONON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-15",
        "last_updated": "2018-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA09312500",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD444557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.