Individual provider Active NPI

Omar Soha

  • Family Medicine Physician
  • Merced, CA
National Provider Identifier
1124416524
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A140097 Issued in CA
Practice address
333 Mercy Ave
Merced, CA 95340-8319
Phone
(209) 564-3500
NPI assigned
Jan 7, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A140097 CA Primary

Addresses

Primary practice location

333 Mercy Ave
Merced, CA 95340-8319

Mailing address

444 W Glenoaks Blvd
Glendale, CA 91202-2917
Phone (818) 552-3000

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20161201001514 CA Practitioner - Family Practice 0244510618 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

444 W Glenoaks Blvd
Glendale, CA 91202-2917
Phone (818) 552-3000

4725 -4733 Sunset Blvd
Los Angeles, CA 90027-6021
Phone (323) 783-4011

4733 W Sunset Blvd
Los Angeles, CA 90027-6021
Phone (213) 667-4784

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A140097CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Permanente Medical Group, Inc CurrentSince Oct 19, 2016 Accepting new patients
Permanente Medical Group Inc Family Medicine Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 19, 2021 Accepting new patients
Permanente Medical Group Inc Family Medicine CurrentSince Oct 19, 2016 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 19, 2021 Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

444 W Glenoaks Blvd
Glendale, CA 91202
Phone (818) 552-3000

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784

1800 Harrison St
Fl 7
Oakland, CA 94612

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

276 Hospital Pkwy
San Jose, CA 95119
Phone (408) 362-4791

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1420588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1124416524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 W GLENOAKS BLVD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912022917",
            "telephone_number": "818-552-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 MERCY AVE",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953408319",
            "telephone_number": "209-564-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOHA",
        "first_name": "OMAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-07",
        "last_updated": "2021-11-29",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A140097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4733 W Sunset Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900276021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

Verify at the official NPI Registry.