Katherine Elizabeth Omernick, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD194500 Issued in OR

Practice address

4010 Aerial Way
Eugene, OR 97402-9757

Phone

(541) 242-8500

Fax

(541) 242-8502

NPI assigned

Jun 9, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Interoperability endpoints

• Direct secure messaging: komernick426070@direct.peacehealth.org

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.

• Peacehealth Medical Group

  • Family Medicine Physician
  • Eugene, OR
  • NPI 1447207287

  Pediatrics

  Medicare reassignment NPD
• Peacehealth

  • Hospitalist Physician
  • Springfield, OR
  • NPI 1740223874
  NPD (past)

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576800000000",
    "number": "1316396385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UW HOSPITALS & CLINICS",
            "address_2": "600 HIGHLAND AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537920001",
            "telephone_number": "414-534-5464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 AERIAL WAY",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974029757",
            "telephone_number": "541-242-8500",
            "fax_number": "541-242-8502"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Hilyard St Ste 440",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974018122",
            "country_code": "US",
            "telephone_number": "458-205-6061",
            "fax_number": "458-205-6066",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Uw Hospitals and Clinics",
            "address_2": "600 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537920001",
            "country_code": "US",
            "telephone_number": "608-263-6400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3377 Riverbend Dr",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OR",
            "postal_code": "974778803",
            "country_code": "US",
            "telephone_number": "541-222-6535",
            "fax_number": "541-222-6539",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OMERNICK",
        "first_name": "KATHERINE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-09",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "1316396385",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD194500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sagen Castellanos Olson, PA-C
• Tonya Karen Olson, MPT
• Lori Oltman
• Cornelius Olufarati
• Dana Lynn Omary, NP
• Omm, LLC
• Oncology Associates of Oregon P C
• Oncology Associates of Oregon P C
• One Step at a Time
• Candice Ongpin Iobst

• Pediatrics Physician in Eugene, OR
• Providers in Eugene, OR by specialty
• Pediatrics Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; 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.