Omar Medical PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

0094907 Issued in FL

Legal business name

OMAR MEDICAL PLLC

Practice address

100 Whetstone PL
Ste 204
St Augustine, FL 32086-5774

Phone

(217) 720-3144

NPI assigned

May 12, 2010

Organization subpart

No

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

Authorized official

Name

Walid Omar, M.D.NPI 1063466845

Title

President

Phone

(217) 720-3144

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Walid Omar, MD

  • Family Medicine Physician
  • St Augustine, FL
  • NPI 1063466845
  Medicare reassignment NPD Authorized official
• Basant M Farghaly, M.D.

  • Family Medicine Physician
  • St Augustine, FL
  • NPI 1104945872
  NPD (past)

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

{
    "created_epoch": "1273622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366934400000",
    "number": "1346568532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WHETSTONE PL",
            "address_2": "STE 204",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865774",
            "telephone_number": "217-720-3144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WHETSTONE PL",
            "address_2": "STE 204",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865774",
            "telephone_number": "217-720-3144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMAR MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-12",
        "last_updated": "2013-04-26",
        "status": "A",
        "authorized_official_last_name": "OMAR",
        "authorized_official_first_name": "WALID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-720-3144",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "0094907",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "0097900",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Oliver, DPT
• Kristin Marie Oliver, CRNP
• Lisa Olschewske, CD(DONA) CLC
• Beth Erin Olson, DPT
• Bryan Daniel Olson, PT, DPT
• Walid Omar, MD
• Jacqueline Atamba Ongayo
• Eric Ordonez, PTA
• Kristen Orlando
• Stacey Orner, RD, LD, MFN

• Specialist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.