Active NPI
Chioma Oti, D.O
- Emergency Medicine Physician
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- OTO12845
- Practice address
- 3998 Red Lion Rd
Philadelphia, PA 19114-1445 - Phone
- (215) 612-2691
- NPI assigned
- Jul 13, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | OTO12845 | PA | |
| Emergency Medicine Physician | 207P00000X | OTO12845 | PA | Primary |
Addresses
Primary practice location
3998 Red Lion Rd
Philadelphia, PA 19114-1445
Mailing address
3998 Red Lion Rd
Philadelphia, PA 19114-1445
Phone (215) 612-2691
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OTO12845 | Medicaid | PA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) | Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- New York College of Osteo Medicine of New York Institute of Technology, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
750 Townpark LN NW
Kennesaw, GA 30144-5579
Phone (770) 514-5405
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTO12845 | PA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Acs Primary Care Physicians - Southeast PC | Emergency Medicine | Current | Accepting new patients |
| Angelfish Emergency Physicians, LLC | Emergency Medicine | Current | Accepting new patients |
| The Bortolazzo Group, LLC | Emergency Medicine | Current | Accepting new patients |
| Phoebe Putney Memorial Hospital Inc | Current | Accepting new patients | |
| Phoebe Putney Memorial Hospital Inc | Current | Accepting new patients | |
| The Southeast Permanente Medical Group | Internal Medicine | Current | Accepting new patients |
Locations
417 W 3rd Ave
Albany, GA 31701
Phone (229) 317-2207
3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000
3651 Wheeler Rd
Augusta, GA 30909
Phone (706) 651-3232
3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752
5126 Hospital Dr NE
Covington, GA 30014
Phone (770) 385-4340
750 Townpark Ln NW
Kennesaw, GA 30144
Phone (770) 514-5401
2151 W Spring St
Monroe, GA 30655
Phone (770) 267-1792
Interoperability endpoints
- https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
Organizations & group practices 6
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.
-
- Internal Medicine Physician
- Atlanta, GA
- NPI 1245266956
-
- Emergency Medicine Physician
- Myrtle Beach, SC
- NPI 1861430555
GA
-
- Emergency Medicine Physician
- Covington, GA
- NPI 1407259500
-
- General Acute Care Hospital
- Albany, GA
- NPI 1992789721
-
- Emergency Medicine Physician
- Austell, GA
- NPI 1801965082
-
- Community/Retail Pharmacy
- Albany, GA
- NPI 1891315420
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642032000000",
"number": "1841429883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3998 RED LION RD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191141445",
"telephone_number": "215-612-2691"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3998 RED LION RD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191141445",
"telephone_number": "215-612-2691"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTI",
"first_name": "CHIOMA",
"name_prefix": "Dr.",
"credential": "D.O",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-13",
"last_updated": "2022-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "OTO12845",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "PA",
"license": "OTO12845",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "OTO12845",
"state": "PA"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "750 Townpark Ln NW",
"city": "Kennesaw",
"state": "GA",
"country_code": "US",
"postal_code": "301445579",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.