Active NPI
Omar Mirza
- Internal Medicine Physician
- Noblesville, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 02007662A
- Practice address
- 9669 E 146TH St Ste 200
Noblesville, IN 46060-5008 - Phone
- (317) 621-6300
- NPI assigned
- Mar 23, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | 02007662A | IN | Primary |
Addresses
Primary practice location
9669 E 146TH St Ste 200
Noblesville, IN 46060-5008
Mailing address
6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890
Other practice location 1
8414 Naab Rd Ste 100
Indianapolis, IN 46260-1972
Phone (317) 338-7510
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Kansas City University of Med & Biosciences, College of Osteo Med, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
9669 E 146TH St
Suite 200
Noblesville, IN 46060-5008
Phone (317) 621-6300
Hospital & facility affiliations
- Community Health at Home LLC
- Community Hospital North
- Community Hospital East
- Community Hospital of Anderson and Madison County
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02007662A | IN | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Physicians of Indiana Inc | Current | Accepting new patients | |
| Community Physicians of Indiana Inc | Internal Medicine | Current | Accepting new patients |
| Major Hospital | Past | Accepting new patients |
Locations
5819 Reliable Pkwy
Chicago, IL 60686
7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444
6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547
9669 E 146th St
Ste 200
Noblesville, IN 46060
Phone (317) 621-6300
Interoperability endpoints
- omirza621609@ecommunitydirect.com
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Indianapolis, IN
- NPI 1619105244
Internal Medicine
-
- Endocrinology, Diabetes & Metabolism Physician
- Carmel, IN
- NPI 1992396337
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Indianapolis, IN
- NPI 1730646589
-
- General Acute Care Hospital
- Indianapolis, IN
- NPI 1336119478
-
- General Acute Care Hospital
- Indianapolis, IN
- NPI 1619163854
-
- General Acute Care Hospital
- Anderson, IN
- NPI 1972500452
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721692800000",
"number": "1184200768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6626 E 75TH ST STE 500",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462502890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9669 E 146TH ST STE 200",
"city": "NOBLESVILLE",
"state": "IN",
"postal_code": "460605008",
"telephone_number": "317-621-6300"
}
],
"practiceLocations": [
{
"address_1": "8414 Naab Rd Ste 100",
"address_purpose": "LOCATION",
"city": "Indianapolis",
"state": "IN",
"postal_code": "462601972",
"country_code": "US",
"telephone_number": "317-338-7510",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MIRZA",
"first_name": "OMAR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-03-23",
"last_updated": "2024-07-23",
"certification_date": "2024-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IN",
"license": "02007662A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Noblesville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.