Asiya Raifovna O'Marra, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C0005887 Issued in MD

Practice address

410 Malcolm Dr Ste E
Westminster, MD 21157-6160

Phone

(410) 876-9300

Fax

(410) 876-4495

NPI assigned

Dec 2, 2015

Last updated

Dec 17, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Asiya Raifovna Fatykhova Former name

Medicare fee-for-service enrollment

Enrolled in MD

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

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Annapolis ENT Surgical Center LLCGroup PAC ID 9436226750, 41 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Annapolis ENT Surgical Center LLC

  dba Chesapeake Specialty Care

  • Specialist
  • Annapolis, MD
  • NPI 1275372617
  Medicare reassignment Care Compare group
• Annapolis ENT Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Annapolis, MD
  • NPI 1629094917
  NPD (past)

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

{
    "created_epoch": "1449014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1366817306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 CROSSROADS DR STE 400",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175490",
            "telephone_number": "410-356-2626",
            "fax_number": "410-356-8945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 MALCOLM DR STE E",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211576160",
            "telephone_number": "410-876-9300",
            "fax_number": "410-876-4495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'MARRA",
        "first_name": "ASIYA",
        "middle_name": "RAIFOVNA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-02",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0005887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASIYA",
            "last_name": "FATYKHOVA",
            "middle_name": "RAIFOVNA",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Juliet Ugochi Nwokedi, PMHNP-BC
• Menplay Nyain, PHARMD
• George Calvin Nyema Sr., CRNP
• Jodelle Nzokou
• Tiffany O'Hara, LCPC
• Dawn Ader O'Meally, LCSW-C
• Wendy Lee O'Meally
• John L. O'Neil, PT, DPT
• Courtney Kirby O'Neill, CRNP
• Obhg Maryland PC

• Physician Assistant in Westminster, MD
• Providers in Westminster, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.
• 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.