Individual provider Active NPI

James E Omohundro, MD

  • Pediatrics Physician
  • Queensbury, NY
National Provider Identifier
1487738175
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
320054 Issued in NY
Practice address
28 S Western Ave
Queensbury, NY 12804-3323
Phone
(518) 798-6400
Fax
(518) 798-4105
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 320054 NY Primary

Addresses

Primary practice location

28 S Western Ave
Queensbury, NY 12804-3323

Mailing address

9 Carey Rd
Queensbury, NY 12804-7880
Phone (518) 761-0300

Other practice location 1

1299 Route 9
Gansevoort, NY 12831-1560
Phone (518) 761-6961

Other practice location 2

38 Larose St
Glens Falls, NY 12801-3452
Phone (518) 824-8181

Other identifiers 1

IdentifierTypeStateIssuer
07545311MedicaidNY

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address james.omohundro.1@1823.direct.athenahealth.com
Direct Messaging Address james.omohundro.1@1823.direct.athenahealth.com
Direct Messaging Address james.omohundro.1@1823.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20230216001736 NY Practitioner - Pediatric Medicine 2264431378 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
320054NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson Headwaters Health Network Pediatrics CurrentSince Mar 13, 2023 Accepting new patients
Hudson Headwaters Health Network Pediatrics Current Accepting new patients
Hudson Headwaters Health Network Pediatrics CurrentSince Mar 13, 2023 Accepting new patients
Hudson Headwaters Health Network Past Accepting new patients

Locations

1299 Route 9
Gansevoort, NY 12831
Phone (518) 761-6961

38 Larose St
Glens Falls, NY 12801
Phone (518) 824-8181

9 Carey Rd
Queensbury, NY 12804

28 S Western Ave
Queensbury, NY 12804
Phone (518) 798-6165

Organizations & group practices 4

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1487738175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CAREY RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128047880",
            "telephone_number": "518-761-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 S WESTERN AVE",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128043323",
            "telephone_number": "518-798-6400",
            "fax_number": "518-798-4105"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1299 Route 9",
            "address_purpose": "LOCATION",
            "city": "Gansevoort",
            "state": "NY",
            "postal_code": "128311560",
            "country_code": "US",
            "telephone_number": "518-761-6961",
            "fax_number": "518-761-1006",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "38 Larose St",
            "address_purpose": "LOCATION",
            "city": "Glens Falls",
            "state": "NY",
            "postal_code": "128013452",
            "country_code": "US",
            "telephone_number": "518-824-8181",
            "fax_number": "833-819-0268",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OMOHUNDRO",
        "first_name": "JAMES",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "320054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07545311",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "james.omohundro.1@1823.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "28 S Western Ave",
            "city": "Queensbury",
            "state": "NY",
            "country_code": "US",
            "postal_code": "128043323",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "james.omohundro.1@1823.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "1299 Route 9",
            "city": "Gansevoort",
            "state": "NY",
            "country_code": "US",
            "postal_code": "128311560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "james.omohundro.1@1823.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "38 Larose St",
            "city": "Glens Falls",
            "state": "NY",
            "country_code": "US",
            "postal_code": "128013452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Queensbury, NY

Sources for this page

Verify at the official NPI Registry.