Active NPI
Ilevba Uwaila Osarenkhoe, MD
- Pediatrics Physician
- Clinton, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- D0067100
- Practice address
- 7503 Surratts Rd
Clinton, MD 20735-3358 - Phone
- (301) 868-8000
- NPI assigned
- Apr 10, 2008
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 255678 | MA | |
| Pediatrics Physician | 208000000X | D0067100 | MD | Primary |
Addresses
Primary practice location
7503 Surratts Rd
Clinton, MD 20735-3358
Mailing address
7503 Surratts Rd
Clinton, MD 20735-3358
Phone (301) 868-8000
Other practice location 1
300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-6000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110097583A | Medicaid | MA |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | ||
| Direct Messaging Address | iosarenkhoe129168@UmassMemorial.direct-ci.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD, VA, DC, ID, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 5
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0067100 | MD | MD | Pediatrics Physician |
| 106361 | MN | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Hospital | Current | Accepting new patients | |
| Medstar Medical Group II LLC | Current | Accepting new patients | |
| Medstar Medical Group II LLC | Current | Accepting new patients | |
| Vpa of Texas PLLC | Current | Accepting new patients | |
| Medstar Medical Group II LLC | Current | Accepting new patients | |
| MGMC LLC | Current | Accepting new patients | |
| Children'S Hospital | Current | Accepting new patients | |
| Vpa of Texas PLLC | Pediatrics | Current | Accepting new patients |
| Children'S Hospital | Pediatrics | Current | Accepting new patients |
| Mdics at Calvert LLC | Current | Accepting new patients | |
| Emergency Medicine Associates, P.a.,P.C. | Current | Accepting new patients | |
| Vpa of Texas PLLC | Current | Accepting new patients | |
| Signify Health, LLC | Current | Accepting new patients | |
| MGMC, LLC | Current | Accepting new patients | |
| PM Pediatrics of Delaware PA | Pediatrics | Past | Accepting new patients |
| PM Pediatrics of New England LLC | Pediatrics | Past | Accepting new patients |
| Medstar Southern Maryland Hospital Center Inc | Past | Accepting new patients |
Locations
3800 Reservoir Rd NW
Washington, DC 20007
Phone (202) 687-2203
1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401
111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670
950 W Bannock St
Ste 1100
Boise, ID 83702
Phone (201) 293-7689
29955 Three Notch Rd
Ste 100
Charlotte Hall, MD 20622
Phone (301) 290-5300
7503 Surratts Rd
Clinton, MD 20735
Phone (301) 868-8000
1406 Crain Hwy S
Glen Burnie, MD 21061
Phone (410) 768-6440
25500 Point Lookout Rd
Leonardtown, MD 20650
Phone (301) 475-6106
100 Hospital Rd
Prnc Frederck, MD 20678
Phone (410) 414-4791
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
4545 Fuller Dr
Ste 325
Irving, TX 75038
Phone (972) 870-5511
1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000
1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100
15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000
1850 Town Center Pkwy
Reston, VA 20190
Phone (703) 478-0922
1806 Summit Ave
Richmond, VA 23230
Phone (213) 433-2823
Interoperability endpoints
- iosarenkhoe49437@direct.southcoast.org
- iosarenkhoe129168@umassmemorial.direct-ci.com
Organizations & group practices 18
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.
-
- Hospitalist Physician
- Prince Frederick, MD
- NPI 1033404207
-
- Children's Hospital
- Washington, DC
- NPI 1912939703
-
- Internal Medicine Physician
- Dulles, VA
- NPI 1376917070
-
dba HarmonyCares Medical Group
- Family Medicine Physician
- Irving, TX
- NPI 1679510499
-
dba Children's National Specialty Pharmacy
- Community/Retail Pharmacy
- Silver Spring, MD
- NPI 1326878349
-
- General Practice Physician
- White Plains, MD
- NPI 1407559081
-
dba Children's National Medical Associates
- Pediatrics Physician
- Washington, DC
- NPI 1780800128
-
- Internal Medicine Physician
- Washington, DC
- NPI 1376887844
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603756800000",
"number": "1992978910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7503 SURRATTS RD",
"city": "CLINTON",
"state": "MD",
"postal_code": "207353358",
"telephone_number": "301-868-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7503 SURRATTS RD",
"city": "CLINTON",
"state": "MD",
"postal_code": "207353358",
"telephone_number": "301-868-8000"
}
],
"practiceLocations": [
{
"address_1": "300 Longwood Ave",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "021155724",
"country_code": "US",
"telephone_number": "617-355-6000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OSARENKHOE",
"first_name": "ILEVBA",
"middle_name": "UWAILA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-10",
"last_updated": "2020-10-27",
"certification_date": "2020-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "255678",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MD",
"license": "D0067100",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110097583A",
"state": "MA"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "60 Hospital Rd",
"city": "Leominster",
"state": "MA",
"country_code": "US",
"postal_code": "014532205",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "iosarenkhoe129168@UmassMemorial.direct-ci.com",
"affiliation": "N",
"address_1": "60 Hospital Rd",
"city": "Leominster",
"state": "MA",
"country_code": "US",
"postal_code": "014532205",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Clinton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; 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.