Individual provider Active NPI

Shadi Omidi, M.D.

  • Obstetrics & Gynecology Physician
  • San Diego, CA
National Provider Identifier
1366454548
Registry record updated Jun 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A61775 Issued in CA
Practice address
10243 Genetic Center Drive
San Diego, CA 92121-6310
Phone
(858) 526-2702
Fax
(858) 526-6113
NPI assigned
Aug 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A61775 CA Primary

Addresses

Primary practice location

10243 Genetic Center Drive
San Diego, CA 92121-6310

Mailing address

2600 Via de la Valle
Ste 200
Del Mar, CA 92014-1992
Phone (858) 499-2702

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20060201000873 CA Practitioner - Obstetrics/GynecologyPractitioner - Ophthalmology 8022022706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

2600 Via de la Valle
Suite 200
Del Mar, CA 92014-1992
Phone (858) 499-2600

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
81.04
Promoting interoperability
99
Improvement activities
40
Cost
82.04

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A61775CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc Obstetrics & Gynecology CurrentSince Oct 7, 2005 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Oct 7, 2005 Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Sharp Rees-Stealy Medical Center Past Accepting new patients
Sharp Memorial Hospital Past Accepting new patients

Locations

2600 Via de la Valle
Ste 200
Del Mar, CA 92014
Phone (858) 309-3160

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

5651 Copley Dr
Ste A
San Diego, CA 92111
Phone (858) 262-6109

10243 Genetic Center Dr
San Diego, CA 92121
Phone (858) 499-2704

Interoperability endpoints

  • Direct secure messaging: somidi32564@sharphealthcare.direct-ci.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402012800000",
    "number": "1366454548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 VIA DE LA VALLE",
            "address_2": "STE 200",
            "city": "DEL MAR",
            "state": "CA",
            "postal_code": "920141992",
            "telephone_number": "858-499-2702",
            "fax_number": "858-309-3119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10243 GENETIC CENTER DRIVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921216310",
            "telephone_number": "858-526-2702",
            "fax_number": "858-526-6113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMIDI",
        "first_name": "SHADI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2014-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A61775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.