MR. OGHENERO LUCKY OLOMUKORO PMHNP-BC
NPI 1437899689
Nurse Practitioner - Psychiatric/Mental Health in Alton, IL

Q: What is Oghenero Olomukoro's NPI number?

The NPI number for Oghenero Olomukoro is 1437899689. It was assigned to this individual provider in the NPPES registry on March 29, 2022.

Q: What is Oghenero Olomukoro's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Active since March 29, 2022PECOS EnrolledAccepts Medicare Assignment

4 MEMORIAL DR STE 210, ALTON, IL 62002(618) 465-8829(618) 465-5499 Get Directions Write a Review

NPPES record last updated: October 12, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 12, 2022, Oct 5, 2022 (2 updates tracked since 2022).

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About Mr. Oghenero Lucky Olomukoro Pmhnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. OGHENERO LUCKY OLOMUKORO PMHNP-BC (NPI 1437899689) is an individual psychiatric/mental health provider in Alton, Illinois, licensed in Illinois (209025704) and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS, is affiliated with Touchette Regional Hospital Inc, and maintains a secondary practice location in Saint Louis.

NPPES Registry Identity

NPI1437899689

Entity TypeIndividualMale

Primary Taxonomy363LP0808X

Provider Legal NameMR. OGHENERO LUCKY OLOMUKOROCredential: PMHNP-BC

Location Address4 MEMORIAL DR STE 210Alton, IL 62002-6704

Mailing Address4 Memorial Dr Ste 210Alton, IL 62002-6704 · (618) 465-8829 · Fax (618) 465-5499

Phone(618) 465-8829

Fax(618) 465-5499

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateMarch 29, 2022

Last NPPES UpdateOctober 12, 20222 updates tracked since enumeration

NPPES CertifiedOctober 12, 2022

✔ NPI 1437899689 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in IL · 209025704

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

4 MEMORIAL DR STE 210, Alton, IL 62002

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Secondary Practice Location 1

Location 113675 Evergreen Glen DrSaint Louis, MO 63128-4273 · Phone (410) 574-4955

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Oghenero Lucky Olomukoro Pmhnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8325415847

PECOS Enrollment IDI20221111002084

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Touchette Regional Hospital Inc

Acute Care Hospitals · Centreville, IL

OwnershipVoluntary non-profit - Private

CMS Certification Number140077

Location5900 Bond AvenueCentreville, IL 62207 · St. Clair County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62002 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.44 typical visit price

range $56.28 – $173.35

Typical copayment $22.11 (range $14.07 – $43.33)

Most-billed visit code 99203

Established Patient

$99.71 typical visit price

range $17.51 – $139.99

Typical copayment $24.92 (range $4.37 – $34.99)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LEE A TARDINO MSN ANP

Nurse Practitioner (Adult Health)