NPIMap

Individual provider Active NPI

Clementina Otomewo, MD

  • Family Medicine Physician
  • State College, PA
National Provider Identifier
1932859733
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD490302 Issued in PA
Practice address
200 Scenery Dr
State College, PA 16801-7974
Phone
(814) 231-4560
Fax
(814) 231-6246
NPI assigned
Mar 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD490302 PA Primary

Addresses

Primary practice location

200 Scenery Dr
State College, PA 16801-7974

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (814) 231-4560

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
I20250918003117 PA Practitioner - Family Practice 9739561549 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

200 Scenery Dr
State College, PA 16801-7974
Phone (814) 231-4560

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Oct 20, 2025 Accepting new patients
Geisinger Clinic Family Medicine Current Accepting new patients
Geisinger Clinic CurrentSince Oct 20, 2025 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

400 Highland Ave
Lewistown, PA 17044
Phone (717) 242-7473

132 Abigail Ln
Port Matilda, PA 16870
Phone (814) 272-5011

200 Scenery Dr
State College, PA 16801
Phone (814) 231-4560

Interoperability endpoints

  • Direct secure messaging: cotomewo497361@direct.geisinger.edu

Organizations & group practices 4

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 35

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1932859733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "814-231-4560",
            "fax_number": "814-231-6246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SCENERY DR",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017974",
            "telephone_number": "814-231-4560",
            "fax_number": "814-231-6246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTOMEWO",
        "first_name": "CLEMENTINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-24",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD490302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

Verify at the official NPI Registry.