Individual provider Active NPI

Dona Mohamed Omar

  • Licensed Practical Nurse
  • Staten Island, NY
National Provider Identifier
1154781185
Registry record updated Mar 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
322646 Issued in NY
Practice address
25 Wright St
Staten Island, NY 10304-2040
Phone
(917) 497-0301
NPI assigned
Mar 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 322646 NY Primary

Addresses

Primary practice location

25 Wright St
Staten Island, NY 10304-2040

Mailing address

25 Wright St
Staten Island, NY 10304-2040
Phone (917) 497-0301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
322646NYMDEmergency Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1456963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456963200000",
    "number": "1154781185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 WRIGHT ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103042040",
            "telephone_number": "917-497-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 WRIGHT ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103042040",
            "telephone_number": "917-497-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMAR",
        "first_name": "DONA",
        "middle_name": "MOHAMED",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-03",
        "last_updated": "2016-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "322646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.