Individual provider Active NPI

Oteng Walebowa, MD

  • Hospitalist Physician
  • Schenectady, NY
National Provider Identifier
1790940971
Registry record updated Nov 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
254904 Issued in NY
Practice address
1101 Nott St
Schenectady, NY 12308-2425
Phone
(518) 243-4135
Fax
(518) 243-1367
NPI assigned
Jul 27, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 254904 NY
Hospitalist Physician 208M00000X 254904 NY Primary

Addresses

Primary practice location

1101 Nott St
Schenectady, NY 12308-2425

Mailing address

1462 Erie Blvd
Schenectady, NY 12305-1026
Phone (518) 243-1020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20091207000375 NY Practitioner - Internal Medicine 3779622675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Albany Medical College of Union University, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ellis HospitalGroup PAC ID 5890607410, 250 clinicians

Practice addresses (Care Compare)

1101 Nott St
Schenecctady, NY 12308-2425
Phone (518) 243-4000

Hospital & facility affiliations

  • Ellis Hospital Hospital, Schenectady, NY, CCN 330153

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
254904NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ellis Hospital CurrentSince Nov 6, 2009 Accepting new patients
Dr. Timothy J. Maggs Chiropractic P.C. PastSince Nov 1, 2001 Accepting new patients
Catholic Charities of Diocese of Albany Past Accepting new patients

Locations

1101 Nott St
Schenectady, NY 12308
Phone (518) 243-1916

600 McClellan St
Schenectady, NY 12304
Phone (518) 382-2000

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 1

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": "1217116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257206400000",
    "number": "1790940971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1462 ERIE BLVD",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123051026",
            "telephone_number": "518-243-1020",
            "fax_number": "518-243-1021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 NOTT ST",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123082425",
            "telephone_number": "518-243-4135",
            "fax_number": "518-243-1367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALEBOWA",
        "first_name": "OTENG",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-27",
        "last_updated": "2009-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "254904",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "254904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schenectady, NY

Sources for this page

Verify at the official NPI Registry.