NPIMap

Individual provider Active NPI

Tina M O'Mara, CRNP

  • Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1023753290
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP025465 Issued in PA
Practice address
333 Cottman Ave
Philadelphia, PA 19111-2434
Phone
(215) 728-4300
NPI assigned
May 3, 2022
Last updated
Sep 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP025465 PA Primary

Addresses

Primary practice location

333 Cottman Ave
Philadelphia, PA 19111-2434

Mailing address

9461 Lansford St
Philadelphia, PA 19114-2625
Phone (215) 380-9237

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tina.omara@fccc.edu

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221014002348 PA Practitioner - Nurse Practitioner 6507232667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Temple University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

333 Cottman Ave
Philadelphia, PA 19111-2434
Phone (215) 707-2111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.21 of 100Reported as group
Quality
49.71
Promoting interoperability
100
Improvement activities
40
Cost
74.23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP025465PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan Inc CurrentSince Jul 1, 2022 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Jul 1, 2022 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients

Locations

333 Cottman Ave
Philadelphia, PA 19111
Phone (215) 728-3893

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

3500 N Broad St
Rm 1A
Philadelphia, PA 19140
Phone (215) 707-2433

Organizations & group practices 3

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 12

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": "1651536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1023753290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9461 LANSFORD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191142625",
            "telephone_number": "215-380-9237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 COTTMAN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112434",
            "telephone_number": "215-728-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'MARA",
        "first_name": "TINA",
        "middle_name": "M",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-03",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP025465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tina.omara@fccc.edu",
            "affiliation": "N",
            "address_1": "333 Cottman Ave",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191112434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.