Active NPI
Walid Omar, MD
- Family Medicine Physician
- St Augustine, FL
National Provider Identifier
1063466845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME94907
- Practice address
- 100 Whetstone PL
Suite 204
St Augustine, FL 32086-5774 - Phone
- (217) 720-3144
- Fax
- (904) 404-8447
- NPI assigned
- May 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME94907 | FL | Primary |
| Hospitalist Physician | 208M00000X | ME94907 | FL |
Addresses
Primary practice location
100 Whetstone PL
Suite 204
St Augustine, FL 32086-5774
Mailing address
100 Whetstone PL
Suite 204
St Augustine, FL 32086-5774
Phone (217) 720-3144
Other practice location 1
820 Prudential Dr Ste 304
Jacksonville, FL 32207-8205
Phone (904) 202-3860
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 274865700 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
100 Whetstone PL
Suite 204
St Augustine, FL 32086-5775
Phone (904) 342-8351
Hospital & facility affiliations
- Medical Services of America Home Health
- Flagler Hospital
- AdventHealth Palm Coast
- Brooks Rehabilitation Hospital University Campus
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Omar Medical PLLC | Current | Accepting new patients | |
| Cobblestone Emergency Physicians | Past | Accepting new patients |
Locations
100 Whetstone Pl
Ste 204
St Augustine, FL 32086
Phone (217) 720-3144
400 Health Park Blvd
St Augustine, FL 32086
Phone (904) 819-4300
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Specialist
- St Augustine, FL
- NPI 1346568532
-
- Emergency Medicine Physician
- St Augustine, FL
- NPI 1134264641
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- St Augustine, FL
- NPI 1144211020
-
- Rehabilitation Hospital
- Jacksonville, FL
- NPI 1376114413
Inpatient rehabilitation facility
-
- Rehabilitation Hospital
- Jacksonville, FL
- NPI 1912947748
Inpatient rehabilitation facility
-
- General Acute Care Hospital
- Palm Coast, FL
- NPI 1679678486
-
- Home Health Agency
- Jacksonville, FL
- NPI 1760434773
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574726400000",
"number": "1063466845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 WHETSTONE PL",
"address_2": "SUITE 204",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320865774",
"telephone_number": "217-720-3144",
"fax_number": "904-404-8447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 WHETSTONE PL",
"address_2": "SUITE 204",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320865774",
"telephone_number": "217-720-3144",
"fax_number": "904-404-8447"
}
],
"practiceLocations": [
{
"address_1": "820 Prudential Dr Ste 304",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322078205",
"country_code": "US",
"telephone_number": "904-202-3860",
"fax_number": "904-202-3846",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OMAR",
"first_name": "WALID",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-19",
"last_updated": "2019-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME94907",
"primary": true
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "FL",
"license": "ME94907",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "274865700",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in St Augustine, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.