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: October 25, 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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Oscar Health, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

Medicare enrollment records show Oghenero Olomukoro reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Illinois Department Of Human Services

3.5 mi

Psychiatric Hospital

4500 COLLEGE AVE
Alton, IL 62002

Reassigned Medicare billing, Illinois enrollment
46 clinicians in this Medicare group

NPI 1083620827 (618) 474-3800

Comprehensive Behavioral Health Center Of St. Clair County, Inc.

19 mi

Substance Abuse Rehabilitation Facility

505 S 8TH ST
East Saint Louis, IL 62201

Reassigned Medicare billing, Illinois enrollment
5 clinicians in this Medicare group

NPI 1063872570 (618) 482-7330

Springs Of Healing LLC

25 mi

Psychiatric/Mental Health

4104 N PARK DR
Belleville, IL 62226

Reassigned Medicare billing, Missouri enrollment

NPI 1902773450 (732) 523-4057

Grow Healthcare Group PA

1,075 mi

Mental Health

66 W FLAGLER ST STE 900
Miami, FL 33130

Reassigned Medicare billing, Illinois enrollment
581 clinicians in this Medicare group

NPI 1245845932 (786) 244-7711

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 17

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)