Active NPI
Michael M Omidi, M.D.
- Plastic and Reconstructive Surgery Physician
- Beverly Hills, CA
National Provider Identifier
1376697599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic and Reconstructive Surgery Physician
- License
- A84519
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A84519 | CA | MD | Plastic and Reconstructive Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Woodlake Ambulatory Surgery Center | Past | Accepting new patients | |
| Almont Ambulatory Surgery Center Inc. | Past | 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.
-
- Clinic/Center
- Pomona, CA
- NPI 1306262282
-
- Ambulatory Surgical Clinic/Center
- Beverly Hills, CA
- NPI 1518907872
-
- Ambulatory Surgical Clinic/Center
- West Hills, CA
- NPI 1578637757
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.