Osayande Abraham Omoregie, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2646 Issued in TN

Practice address

3443 Dickerson Pike Ste 730
Nashville, TN 37207-2527

Phone

(615) 972-1100

Fax

(615) 537-4950

NPI assigned

Oct 22, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Interventional Pain Center, PLLCGroup PAC ID 8628217973, 8 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

73.3 of 100Reported as group

Quality

52.15

Improvement activities

40

Cost

74.81

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: osayande.omoregie@1533.securemail.prognocis.com

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.

• Interventional Pain Center, PLLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Hendersonville, TN
  • NPI 1285976407
  Medicare reassignment Care Compare group
• Interventional Pain Center, PLLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Hendersonville, TN
  • NPI 1083154819
  NPD

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

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1942605779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 NEW SHACKLE ISLAND RD STE 148C",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370752366",
            "telephone_number": "615-972-1100",
            "fax_number": "615-537-4950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3443 DICKERSON PIKE STE 730",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372072527",
            "telephone_number": "615-972-1100",
            "fax_number": "615-537-4950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "353 New Shackle Island Rd Ste 148C",
            "address_purpose": "LOCATION",
            "city": "Hendersonville",
            "state": "TN",
            "postal_code": "370752366",
            "country_code": "US",
            "telephone_number": "615-972-1100",
            "fax_number": "615-537-4950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OMOREGIE",
        "first_name": "OSAYANDE",
        "middle_name": "ABRAHAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-22",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "2646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q016673",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Omni Visions, Inc.
• Laurie Frances Omohundro, NP
• Ukpebo Rebecca Omosigho, MD
• Omspt Holdings LLC
• Omspt Holdings LLC
• On Time Non Emergency Medical Transportation LLC
• On Your Mind Counseling, LLC

• Physician Assistant in Nashville, TN
• Providers in Nashville, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; 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.

Verify at the official NPI Registry.