Goda Orentaite, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

9760 S Kedzie Ave Ste 3
Evergreen Park, IL 60805-3184

Phone

(708) 423-6209

NPI assigned

Sep 13, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: goda.orentaite.2@27901.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Park Primary Care LTD

  • General Practice Physician
  • Evergreen Park, IL
  • NPI 1891984068

  Single Specialty

  Medicare reassignment NPD
• Evergreen Care Center LTD

  • General Practice Physician
  • Evergreen Park, IL
  • NPI 1447449616
  Medicare reassignment

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

{
    "created_epoch": "1663027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1861114373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9760 S KEDZIE AVE STE 3",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608053184",
            "telephone_number": "708-423-6209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9760 S KEDZIE AVE STE 3",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608053184",
            "telephone_number": "708-423-6209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORENTAITE",
        "first_name": "GODA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-13",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica L Olson, LCPC
• Iyad S Omar, R.D.H, B.S.
• Margaret Omole, P.T
• Chijoke H Onyenwenyi, MD
• Optech Orthotics & Prosthetics Services, LTD
• Sarah Orsi, HEARING INSTR. SPECI
• Osf Healthcare System (OSF Little Company of Mary Medical Center)
• Osf Healthcare System (OSF Little Company of Mary Medical Center)
• Osf Healthcare System (OSF Little Company of Mary Medical Center)
• Osf Multi-Specialty Group (OSF OnCall Urgent Care)

• Physician Assistant in Evergreen Park, IL
• Providers in Evergreen Park, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.