Om R Pathak, DO

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

20A24172 Issued in CA

Practice address

30448 Rancho Viejo Rd
San Juan Capistrano, CA 92675-1513

Phone

(949) 489-9342

NPI assigned

Mar 23, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Interoperability endpoints

• Direct secure messaging: om.pathak.1@21138.direct.athenahealth.com

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766102400000",
    "number": "1174109763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30448 RANCHO VIEJO RD",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30448 RANCHO VIEJO RD",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751513",
            "telephone_number": "949-489-9342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATHAK",
        "first_name": "OM",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-23",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "20A24172",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert R Paredes Sr., MD
• Tina Parsaee
• Partners in Health
• Jay Ashwinbhai Patel, MD
• Stefani Pateryn, DNP, PMHNP-BC, PHN
• Pathways to Recovery
• Patricia Tay DDS Inc
• Pamela Patterson, CNA, CHHA
• Sarah Whitney Patterson, MFTA
• Sarah Elizabeth Pelangka, PH D., BCBA-D, E.S.C

• General Practice Physician in San Juan Capistrano, CA
• Providers in San Juan Capistrano, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.