Faithcaren Omongo, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA13513 Issued in TX

Practice address

610 S Watters Rd Ste 130
Allen, TX 75013-5008

Phone

(469) 854-3263

NPI assigned

Jun 24, 2020

Last updated

Dec 27, 2022By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1437775491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 S WATTERS RD STE 130",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750135008",
            "telephone_number": "469-854-3263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 S WATTERS RD STE 130",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750135008",
            "telephone_number": "469-854-3263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMONGO",
        "first_name": "FAITHCAREN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-24",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA13513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.geodehealth.com/locations/allen-tx/?utm_source=google&utm_medium=organic&utm_campaign=googlemybusiness",
            "affiliation": "N",
            "endpointDescription": "company website",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "company website",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "company website",
            "address_1": "610 S Watters Rd Ste 130",
            "city": "Allen",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750135008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physician Assistant in Allen, TX
• Providers in Allen, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; 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.

Verify at the official NPI Registry.