Individual provider Active NPI

Omar Anthony Valencia Eslao, M.D.

  • Psychiatry Physician
  • Lancaster, CA
National Provider Identifier
1518112606
Registry record updated Nov 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A116494 Issued in CA
Practice address
44444 20TH St W
Lancaster, CA 93534-2714
Phone
(661) 951-0070
NPI assigned
Nov 17, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2021

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 A116494 CA Primary

Addresses

Primary practice location

44444 20TH St W
Lancaster, CA 93534-2714

Mailing address

44444 20TH St W
Lancaster, CA 93534-2714
Phone (661) 951-0070

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20130514000389 CA Practitioner - Psychiatry 7214082106 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Saint Louis University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

13652 Cantara St
Panorama City, CA 91402-5423
Phone (818) 375-2000

44444 20TH St W
Lancaster, CA 93534-2714
Phone (661) 951-2826

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health CurrentSince Mar 23, 2013 Accepting new patients
Southern California Permanente Medical Group CurrentSince Mar 4, 2014 Accepting new patients
Southern California Permanente Medical Group CurrentSince Mar 4, 2014 Accepting new patients
Los Angeles County Department of Mental Health Current Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Mar 23, 2013 Accepting new patients
Childrens Center for Treatment and Education Past Accepting new patients

Locations

43112 15th St W
Lancaster, CA 93534
Phone (661) 726-2222

44444 20th St W
Lancaster, CA 93534
Phone (661) 951-0070

4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

1529 E Palmdale Blvd
Ste 150
Palmdale, CA 93550
Phone (661) 575-1800

2260 E Palmdale Blvd
Ste J
Palmdale, CA 93550
Phone (661) 575-1800

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

Organizations & group practices 7

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": "1226880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1518112606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44444 20TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342714",
            "telephone_number": "661-951-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44444 20TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342714",
            "telephone_number": "661-951-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESLAO",
        "first_name": "OMAR ANTHONY",
        "middle_name": "VALENCIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-17",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A116494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "43112 N 15th St",
            "city": "LANCASTER",
            "state": "CA",
            "country_code": "US",
            "postal_code": "935346219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.