Individual provider Active NPI

Jessica O'Mara

  • Psychiatry Physician
  • Grand Rapids, MI
National Provider Identifier
1457766917
Registry record updated Jun 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
5101021373 Issued in MI
Practice address
300 68TH St SE
Grand Rapids, MI 49548-6927
Phone
(616) 456-0857
NPI assigned
Jun 24, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 5101021373 MI Primary

Addresses

Primary practice location

300 68TH St SE
Grand Rapids, MI 49548-6927

Mailing address

300 68TH St SE
Grand Rapids, MI 49548-6927

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20170914000352 MI Practitioner - Psychiatry 5890090914 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Ohio University, College of Osteopathic Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MCCD FL Psychiatry Services PAGroup PAC ID 4880064070, 751 clinicians

Practice addresses (Care Compare)

4200 Fashion Square Blvd
Saginaw, MI 48603-1375
Phone (833) 351-8255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
MCCD FL Psychiatry Services PA Psychiatry CurrentSince Apr 21, 2025 Accepting new patients
St Mary Mercy Physician Practices CurrentSince May 1, 2022 Accepting new patients
Iha Olma Specialty 1 LLC Current Accepting new patients
Pine Rest Christian Mental Health Services Psychiatry CurrentSince Jun 19, 2019 Accepting new patients
Iha Olma Specialty 1 LLC CurrentSince Sep 23, 2023 Accepting new patients
Pine Rest Christian Mental Health Services Current Accepting new patients
Iha Olma Specialty 1 LLC Psychiatry CurrentSince Sep 23, 2023 Accepting new patients
St Mary Mercy Physician Practices CurrentSince May 1, 2022 Accepting new patients
Pine Rest Christian Mental Health Services CurrentSince Jun 19, 2019 Accepting new patients

Locations

455 E Eisenhower Pkwy
Ste 300
Ann Arbor, MI 48108
Phone (517) 580-5727

19000 St Joes Pkwy
Livonia, MI 48152
Phone (734) 655-8250

19000 St Joes Pkwy
Ste 210
Livonia, MI 48152
Phone (734) 655-8250

19000 St Joes Pkwy
Ste 310
Livonia, MI 48152
Phone (248) 743-4490

4200 Fashion Square Blvd
Ste 201
Saginaw, MI 48603
Phone (872) 368-4123

300 68th St SE
Wyoming, MI 49548
Phone (616) 455-5000

109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572

Organizations & group practices 9

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": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403568000000",
    "number": "1457766917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927",
            "telephone_number": "616-456-0857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'MARA",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-24",
        "last_updated": "2014-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "5101021373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.