Individual provider Active NPI

Omar Al Dhaybi, M.D.

  • Nephrology Physician
  • New York, NY
National Provider Identifier
1013271535
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
328469 Issued in NY
Practice address
1190 5TH Ave
New York, NY 10029-6503
Phone
(212) 427-1540
Fax
(212) 251-9114
NPI assigned
Jun 28, 2012
Last updated
Feb 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hypertension Specialist Physician 207RH0005X 328469 NY
Nephrology Physician 207RN0300X 328469 NY Primary

Addresses

Primary practice location

1190 5TH Ave
New York, NY 10029-6503

Mailing address

1 Gustave L Levy PL # 1118
New York, NY 10029-6504

Other practice location 1

1 Gustave L Levy Pl
New York, NY 10029-6504
Phone (212) 427-1540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240925001689 NY Practitioner - Nephrology 0345542932 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Gustave L Levy PL
New York, NY 10029-6504
Phone (212) 731-7822

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11301AWYMDCardiovascular Disease Physician
328469NYMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 1, 2024 Accepting new patients
Nephrology Associates of Northern Indiana, Inc Nephrology CurrentSince Mar 1, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 1, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

120 W 22nd St
Ste 200
Oak Brook, IL 60523
Phone (630) 575-5000

569 Tyler St
Gary, IN 46402
Phone (260) 885-3300

90 W 86th Ave
Merrillville, IN 46410
Phone (219) 791-1555

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

1190 5th Ave
New York, NY 10029
Phone (212) 241-6756

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

10114 Liberty Ave
Ozone Park, NY 11417
Phone (718) 487-3330

Networks

  • IL PPO Downstate
  • Healthfirst Medicare Network H5989
  • IL HMO C-SNP
  • Healthfirst Medicare Network H1722
  • devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: oaldhaybi33074@direct.crmcwy.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1340841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1013271535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL # 1118",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296503",
            "telephone_number": "212-427-1540",
            "fax_number": "212-251-9114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Gustave L Levy Pl",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100296504",
            "country_code": "US",
            "telephone_number": "212-427-1540",
            "fax_number": "212-410-7196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AL DHAYBI",
        "first_name": "OMAR",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-28",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0005X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hypertension Specialist",
            "state": "NY",
            "license": "328469",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "328469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.