Individual provider Active NPI

Omer Cermik, MD

  • Psychiatry Physician
  • Johnston, RI
National Provider Identifier
1093721805
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD10213 Issued in RI
Practice address
1443 Hartford Ave
Johnston, RI 02919-3224
Phone
(401) 273-8100
Fax
(401) 861-8696
NPI assigned
Aug 1, 2006
Last updated
Mar 12, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD10213 RI Primary

Addresses

Primary practice location

1443 Hartford Ave
Johnston, RI 02919-3224

Mailing address

117 Ellenfield St Ste 101
Providence, RI 02905-4541

Other identifiers 5

IdentifierTypeStateIssuer
15-26435OtherRIUBH
22129-8OtherRIBLUE CROSS
406989OtherRIBLUE CHIP
007059462OtherRIMEDICARE ID-TYPE UNSPECIFIED
7007566MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20060922000318 RI Practitioner - Psychiatry 6204831357 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gateway Healthcare IncGroup PAC ID 7719874908, 66 clinicians

Practice addresses (Care Compare)

1443 Hartford Ave
Johnston, RI 02919-3224
Phone (401) 273-8100

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Alliance CurrentSince Sep 28, 2022 Accepting new patients
Family Service of Rhode Island, Inc. CurrentSince Jun 5, 2023 Accepting new patients
Gateway Healthcare Inc CurrentSince Apr 6, 2025 Accepting new patients
The Providence Center Psychiatry Past Accepting new patients
The Providence Center Past Accepting new patients
Barreto & Schwartz Psychology Associates PC Inc Past Accepting new patients

Locations

1516 Atwood Ave
Johnston, RI 02919
Phone (401) 463-8829

1 Virginia Ave
Ste 200
Providence, RI 02905

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

1443 Hartford Ave
Providence, RI 02919
Phone (401) 273-8100

55 Hope St
Providence, RI 02906
Phone (401) 519-2230

55 John a Cummings Way
Woonsocket, RI 02895
Phone (401) 235-7021

800 Clinton St
Woonsocket, RI 02895
Phone (401) 235-7469

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1093721805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1443 HARTFORD AVE",
            "city": "JOHNSTON",
            "state": "RI",
            "postal_code": "029193224",
            "telephone_number": "401-273-8100",
            "fax_number": "401-861-8696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERMIK",
        "first_name": "OMER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "RI",
            "license": "MD10213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "15-26435",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "22129-8",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "406989",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID-TYPE UNSPECIFIED",
            "identifier": "007059462",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7007566",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnston, RI

Sources for this page

Verify at the official NPI Registry.