NPIMap

Organization Active NPI

Omni Medical Group PLLC

  • Internal Medicine Physician
  • Woodside, NY
National Provider Identifier
1497136790
Registry record updated Jun 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
237709 Issued in NY
Legal business name
OMNI MEDICAL GROUP PLLC
Practice address
6413 Broadway
Woodside, NY 11377-2336
Phone
(718) 205-6561
NPI assigned
Jun 11, 2015
Last updated
Jun 11, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2015

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

Authorized official

Name
Dr. Shamim Ahmed, MDNPI 1003839655
Title
Managing Partner
Phone
(718) 205-6561

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 237709 NY Primary

Addresses

Primary practice location

6413 Broadway
Woodside, NY 11377-2336

Mailing address

10 Barrypark CT
Albertson, NY 11507-1502
Phone (718) 205-6561

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433980800000",
    "number": "1497136790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 BARRYPARK CT",
            "city": "ALBERTSON",
            "state": "NY",
            "postal_code": "115071502",
            "telephone_number": "718-205-6561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6413 BROADWAY",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113772336",
            "telephone_number": "718-205-6561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNI MEDICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-11",
        "last_updated": "2015-06-11",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "SHAMIM",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "718-205-6561",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "237709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.