Individual provider Active NPI

Brandon Michael O'Malley, MD

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1174180715
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
125.074667 Issued in IL
Practice address
7435 W Talcott Ave
Chicago, IL 60631-3707
Phone
(773) 792-7921
NPI assigned
May 20, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 125.074667 IL Primary

Addresses

Primary practice location

7435 W Talcott Ave
Chicago, IL 60631-3707

Mailing address

7435 W Talcott Ave
Chicago, IL 60631-3707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20220805000154 OH Practitioner - Emergency Medicine 7315375680 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.074667ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Qualified Emergency Specialists Inc Emergency Medicine CurrentSince Aug 1, 2022 Accepting new patients

Locations

375 Dixmyth Ave
Cincinnati, OH 45220
Phone (513) 862-2432

6949 Good Samaritan Dr
Cincinnati, OH 45247
Phone (513) 246-9800

3125 Hamilton Mason Rd
Fairfield Township, OH 45011
Phone (513) 394-8888

100 Arrow Springs Blvd
Lebanon, OH 45036
Phone (513) 282-7000

10500 Montgomery Rd
Montgomery, OH 45242
Phone (513) 557-3206

110 N Poplar St
Oxford, OH 45056
Phone (513) 523-2111

Organizations & group practices 1

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": "1558310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1174180715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7435 W TALCOTT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7435 W TALCOTT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313707",
            "telephone_number": "773-792-7921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'MALLEY",
        "first_name": "BRANDON",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-20",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125.074667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.