Michael Omomo

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

7837 Issued in MN

Practice address

7400 Metro Blvd Ste 215
Edina, MN 55439-2321

Phone

(631) 533-2990

Fax

(651) 666-1396

NPI assigned

Oct 22, 2020

Last updated

Mar 31, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Zenith Healthcare

  • Psychiatric/Mental Health Nurse Practitioner
  • Edina, MN
  • NPI 1891530077

  Single Specialty

  Medicare reassignment NPD Authorized official
• Ralphvan Healthcare LLC

  • Home Health Agency
  • Edina, MN
  • NPI 1467233759
  Authorized official Same address or phone

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1427657139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 METRO BLVD STE 215",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392321",
            "telephone_number": "631-533-2990",
            "fax_number": "651-666-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 METRO BLVD STE 215",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392321",
            "telephone_number": "631-533-2990",
            "fax_number": "651-666-1396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMOMO",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-22",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "7837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danly Osmary Omil-Lima, MD
• James Joseph Omlie, D.D.S.
• Mark R Omlie, D.D.S.-M.D.
• William R. Omlie, M.D.
• Omni HHC, Inc. (CareMinders Home Care)
• On-Site Dentistry (On-Site Podiatry Services)
• On-Site Dentistry
• On-Site Dentistry
• On-Site Hearing Services, Inc.
• On-Site Podiatry, Inc

• Psychiatric/Mental Health Nurse Practitioner in Edina, MN
• Providers in Edina, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2026; 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.