NPIMap

Individual provider Active NPI

Shuaib O Okponobi, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Pittsburgh, PA
National Provider Identifier
1821221789
Registry record updated Oct 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
MD448454 Issued in PA
Practice address
320 E North Ave
Pittsburgh, PA 15212-4756
Phone
(412) 359-6886
NPI assigned
Aug 26, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD448454 PA Primary

Addresses

Primary practice location

320 E North Ave
Pittsburgh, PA 15212-4756

Mailing address

320 E North Ave
Pittsburgh, PA 15212-4756
Phone (412) 359-6886

Other practice location 1

751 Liberty St
Meadville, PA 16335-2559
Phone (814) 333-5518

Other identifiers 2

IdentifierTypeStateIssuer
1030340500001MedicaidPA
0136818MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sokponobi286810@direct.ahn.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20150721001363 PA Practitioner - Pathology 1557674496 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allegheny ClinicGroup PAC ID 5395649586, 2,313 clinicians

Practice addresses (Care Compare)

12311 Perry Hwy
Wexford, PA 15090-8344
Phone (412) 359-3457

12351 Perry Hwy
Wexford, PA 15090-8344
Phone (412) 359-6581

1301 Carlisle St
Natrona Heights, PA 15065-1152
Phone (724) 226-7380

320 E N Ave
Pittsburgh, PA 15212-4756

4800 Friendship Ave
Pittsburgh, PA 15224-1722

565 Coal Valley Rd
Jefferson Hills, PA 15025-3703
Phone (412) 267-6901

631 N Broad St Ext
Grove City, PA 16127-4603

631 N Broad St Extension
Agh Radiation Oncology
Grove City, PA 16127-4603
Phone (724) 450-7182

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD448454PAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allegheny Clinic Current Accepting new patients
Steward Medical Group, Inc CurrentSince May 1, 2017 Accepting new patients
Steward Medical Group Inc. CurrentSince May 1, 2017 Accepting new patients
Allegheny Clinic Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2015 Accepting new patients
Allegheny Clinic CurrentSince Jul 1, 2015 Accepting new patients

Locations

2320 Highland Rd
Hermitage, PA 16148
Phone (724) 983-5900

62 Greenbriar Dr
Ste 1
Leechburg, PA 15656
Phone (724) 845-7765

751 Liberty St
Meadville, PA 16335
Phone (814) 333-5081

1301 Carlisle St
Natrona Hts, PA 15065
Phone (724) 224-5100

320 E North Ave
Pittsburgh, PA 15212
Phone (412) 359-3131

740 E State St
Sharon, PA 16146
Phone (724) 983-1980

951 Male Rd
Wind Gap, PA 18091
Phone (610) 654-1000

Organizations & group practices 5

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": "1251244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1821221789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 E NORTH AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152124756",
            "telephone_number": "412-359-6886",
            "fax_number": "412-359-3598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E NORTH AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152124756",
            "telephone_number": "412-359-6886"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "751 Liberty St",
            "address_purpose": "LOCATION",
            "city": "Meadville",
            "state": "PA",
            "postal_code": "163352559",
            "country_code": "US",
            "telephone_number": "814-333-5518",
            "fax_number": "814-333-5987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OKPONOBI",
        "first_name": "SHUAIB",
        "middle_name": "O",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-26",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "PA",
            "license": "MD448454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1030340500001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0136818",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sokponobi286810@direct.ahn.org",
            "affiliation": "N",
            "address_1": "320 E North Ave",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152124756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.