Provider Demographics
NPI:1477698991
Name:RICHARD O. ONI, MD, INC
Entity Type:Organization
Organization Name:RICHARD O. ONI, MD, INC
Other - Org Name:ORTHOPAEDIC SURGEONS, LTD.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:O
Authorized Official - Last Name:ONI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-884-1551
Mailing Address - Street 1:5525 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-2782
Mailing Address - Country:US
Mailing Address - Phone:219-884-1551
Mailing Address - Fax:219-887-6334
Practice Address - Street 1:5525 BROADWAY
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-2782
Practice Address - Country:US
Practice Address - Phone:219-884-1551
Practice Address - Fax:219-887-6334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01030980A207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200014830BMedicaid
IN100166600AMedicaid
IN000000085298OtherBCBS OF INDIANA
IN200014830AMedicaid
IL91107850OtherBCBS OF ILL
IN200014830AMedicaid
IN214130Medicare PIN
IN100166600AMedicaid
IN0891670001Medicare NSC
IN200018479Medicare PIN