Ebrahim Rashid Oomerjee, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A132078 Issued in CA

Practice address

Stony Brook University Medical Center
Department of Pediatrics HSC T-11 040
Stony Brook, NY 11794-8111

Phone

(631) 444-2020

Fax

(631) 444-2894

NPI assigned

Apr 20, 2011

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

Electronic endpoints 1

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Riverside, CA
  • NPI 1316979834
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Bakersfield, CA
  • NPI 1861424376
  NPD

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

{
    "created_epoch": "1303257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1285925636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "STONY BROOK UNIVERSITY MEDICAL CENTER",
            "address_2": "DEPARTMENT OF PEDIATRICS HSC T-11 040",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948111",
            "telephone_number": "631-444-2020",
            "fax_number": "631-444-2894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STONY BROOK UNIVERSITY MEDICAL CENTER",
            "address_2": "DEPARTMENT OF PEDIATRICS HSC T-11 040",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948111",
            "telephone_number": "631-444-2020",
            "fax_number": "631-444-2894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OOMERJEE",
        "first_name": "EBRAHIM",
        "middle_name": "RASHID",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-20",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A132078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3733 San Dimas St",
            "city": "Bakersfield",
            "state": "CA",
            "country_code": "US",
            "postal_code": "933011407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pediatrics Physician in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.