Individual provider Active NPI

Oladimeji A Omitoogun, PT

  • Orthopedic Physical Therapist
  • Greensboro, NC
National Provider Identifier
1770196479
Registry record updated Aug 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
P19330 Issued in NC
Practice address
3200 Northline Ave Ste 160
Greensboro, NC 27408-7613
Phone
(336) 545-5000
Fax
(336) 544-1216
NPI assigned
Aug 24, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X P19330 NC Primary

Addresses

Primary practice location

3200 Northline Ave Ste 160
Greensboro, NC 27408-7613

Mailing address

3200 Northline Ave Ste 160
Greensboro, NC 27408-7613
Phone (336) 545-5000

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Greensboro

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201016001036 NC Practitioner - Physical Therapist in Private Practice 4385064195 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergeortho PAGroup PAC ID 0749188894, 726 clinicians

Practice addresses (Care Compare)

120 William Penn PLZ
Durham, NC 27704-2150
Phone (919) 220-5255

3200 Northline Ave
Suite 200
Greensboro, NC 27408-7602
Phone (336) 545-5000

Merit-based Incentive Payment System (MIPS)

Final score
89.07 of 100Reported as group
Quality
85.94
Promoting interoperability
100
Improvement activities
40
Cost
77.63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Emergeortho PA CurrentSince Sep 14, 2020 Accepting new patients
Emergeortho PA CurrentSince Sep 14, 2020 Accepting new patients

Locations

120 William Penn Plz
Durham, NC 27704
Phone (919) 281-1836

3200 Northline Ave
Ste 160
Greensboro, NC 27408
Phone (336) 545-3530

Interoperability endpoints

  • Direct secure messaging: oladimeji.omitoogun.1@847.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1598227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1770196479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 NORTHLINE AVE STE 160",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087613",
            "telephone_number": "336-545-5000",
            "fax_number": "336-544-1216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 NORTHLINE AVE STE 160",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087613",
            "telephone_number": "336-545-5000",
            "fax_number": "336-544-1216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMITOOGUN",
        "first_name": "OLADIMEJI",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-24",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NC",
            "license": "P19330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Greensboro",
            "affiliation": "N",
            "endpointDescription": "EmergeOrtho, PA",
            "address_1": "3200 Northline Ave Ste 160",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274087613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.