Peter Omonde II, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

102580 Issued in NC

Practice address

120 W. Martin Luther KNG Jr. Drive
Washington, NC 27889

Phone

(252) 940-0602

Fax

(252) 940-0605

NPI assigned

Feb 7, 2006

Last updated

Apr 15, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Metropolitan Community Health Services, Inc

  dba Agape Community Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Washington, NC
  • NPI 1366488280
  Medicare reassignment NPD (past)
• Metropolitan Community Health Services, Inc.

  dba Agape Health Services- Plymouth

  • Federally Qualified Health Center (FQHC)
  • Plymouth, NC
  • NPI 1326627399
  NPD
• Metropolitan Community Health Services, Inc.

  dba Agape Health Services - Carolina Avenue

  • Federally Qualified Health Center (FQHC)
  • Washington, NC
  • NPI 1891590444
  NPD

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429056000000",
    "number": "1245202738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 N EDEN DR",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893114",
            "telephone_number": "252-940-0602",
            "fax_number": "252-940-0605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W. MARTIN LUTHER KNG JR. DRIVE",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "27889",
            "telephone_number": "252-940-0602",
            "fax_number": "252-940-0605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMONDE",
        "first_name": "PETER",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2015-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "102580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "344591C",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FQHC MEDICAID",
            "identifier": "344591A/344591C",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FQHC MEDICARE",
            "identifier": "341871",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Misty O'Neal, M.S. CCC-SLP
• Morgen F Obermeit, DPT
• Obstetrics & Gynecology of Washington
• Occupational Therapy Plus, Inc.
• Sharon J Octigan, HEALTH EDUCATOR
• Options to Domestic Violence & Sexual Assault Inc.
• Marilyn Yvonne Ore-Booth, LCSW
• Marleen Ore
• Gabriella Mesquita Overby
• Becky Winslow Overman, BS, PHARMD, RPH

• Physician Assistant in Washington, NC
• Providers in Washington, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2015; 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.