Individual provider Active NPI

Jaime Joaquin Alix Omega, NP

  • Nurse Practitioner
  • Raleigh, NC
National Provider Identifier
1346945953
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5017893 Issued in NC
Practice address
1540 Sunday Dr
Raleigh, NC 27607-6010
Phone
(919) 782-3456
Fax
(919) 783-1441
NPI assigned
Apr 3, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5017893 NC Primary

Addresses

Primary practice location

1540 Sunday Dr
Raleigh, NC 27607-6010

Mailing address

1540 Sunday Dr
Raleigh, NC 27607-6010
Phone (919) 782-3456

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230422000211 NC Practitioner - Nurse Practitioner 3173988391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

2701 Pickett Rd
Durham, NC 27705-5688
Phone (919) 419-9600

Hospital & facility affiliations

  • Medi Home Health Agency Home health agency, Raleigh, NC, CCN 347237
  • Rex Hospital Hospital, Raleigh, NC, CCN 340114

Merit-based Incentive Payment System (MIPS)

Final score
85 of 100Reported as group
Quality
65.93
Promoting interoperability
100
Improvement activities
40
Cost
84.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Raleigh Neurology Associates, P. a. CurrentSince Apr 10, 2023 Accepting new patients

Locations

1520 Sunday Dr
Raleigh, NC 27607
Phone (919) 782-3456

1540 Sunday Dr
Raleigh, NC 27607
Phone (919) 782-3456

Interoperability endpoints

  • Direct secure messaging: jaime.joaquin.alix.omega.1@25810.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/25810/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1346945953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 SUNDAY DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076010",
            "telephone_number": "919-782-3456",
            "fax_number": "919-783-1441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 SUNDAY DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076010",
            "telephone_number": "919-782-3456",
            "fax_number": "919-783-1441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMEGA",
        "first_name": "JAIME JOAQUIN",
        "middle_name": "ALIX",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5017893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.