Organization Active NPI

Omidvari Psychiatry P.C.

Doing business as Wele Clinic

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1194524678
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
OMIDVARI PSYCHIATRY P.C.
Doing business as
Wele Clinic
Practice address
1123 Broadway Ste 1117
New York, NY 10010-2007
Phone
(646) 874-9340
Fax
(646) 809-8701
NPI assigned
Mar 10, 2025
Last updated
Mar 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Authorized official

Name
Dr. Mohammadmehdi Omidvari, MDNPI 1194137760
Title
Director
Phone
(646) 874-9340

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

1123 Broadway Ste 1117
New York, NY 10010-2007

Mailing address

73 Van Etten Blvd
New Rochelle, NY 10804-2319

Other names 1

  • Wele Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250425001065 NY Part B Supplier - Clinic/Group Practice 5698291318 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

1123 Broadway
Ste 1117
New York, NY 10010
Phone (212) 253-0030

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1741564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741564800000",
    "number": "1194524678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 VAN ETTEN BLVD",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108042319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1123 BROADWAY STE 1117",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100102007",
            "telephone_number": "646-874-9340",
            "fax_number": "646-809-8701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMIDVARI PSYCHIATRY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-10",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-09",
        "status": "A",
        "authorized_official_last_name": "OMIDVARI",
        "authorized_official_first_name": "MOHAMMADMEHDI",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "646-874-9340",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wele Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.