Individual provider Active NPI

Michael M Omidi, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Beverly Hills, CA
National Provider Identifier
1376697599
Registry record updated Sep 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
A84519 Issued in CA
Practice address
9001 Wilshire Blvd
Suite 106
Beverly Hills, CA 90211-1838
Phone
(310) 273-8885
NPI assigned
Jan 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X A84519 CA Primary

Addresses

Primary practice location

9001 Wilshire Blvd
Suite 106
Beverly Hills, CA 90211-1838

Mailing address

9001 Wilshire Blvd
Suite 106
Beverly Hills, CA 90211-1838
Phone (310) 273-8885

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
I20050322000540 CA Practitioner - General SurgeryPractitioner - Maxillofacial SurgeryPractitioner - Vascular SurgeryPractitioner - Plastic and Reconstructive SurgeryPractitioner - Hand Surgery 1254386329 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A84519CAMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Woodlake Ambulatory Surgery Center PastSince Mar 1, 2006 Accepting new patients
Almont Ambulatory Surgery Center Inc. PastSince Jul 26, 2006 Accepting new patients

Organizations & group practices 3

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": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190073600000",
    "number": "1376697599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9001 WILSHIRE BLVD",
            "address_2": "SUITE 106",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902111838",
            "telephone_number": "310-273-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9001 WILSHIRE BLVD",
            "address_2": "SUITE 106",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902111838",
            "telephone_number": "310-273-8885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMIDI",
        "first_name": "MICHAEL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A84519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.