Individual provider Active NPI

Omar Doria

  • Physician Assistant
  • Rio Grande City, TX
National Provider Identifier
1548613706
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10542 Issued in TX
Practice address
201 E 2ND St
Rio Grande City, TX 78582-3803
Phone
(956) 488-1200
Fax
(956) 488-9500
NPI assigned
Jul 22, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10542 TX Primary

Addresses

Primary practice location

201 E 2ND St
Rio Grande City, TX 78582-3803

Mailing address

201 E 2ND St
Rio Grande City, TX 78582-3803
Phone (956) 488-1200

Other practice location 1

605 N Main St Ste B
Donna, TX 78537-2726
Phone (956) 464-4407

Other practice location 2

105 E Polk Ave
Pharr, TX 78577-3110
Phone (956) 781-6591

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240606003067 TX Practitioner - Physician Assistant 1759823651 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA10542TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
All Children'S Pediatric Clinic P.a. Past Accepting new patients

Organizations & group practices 2

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": "1469145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1548613706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E 2ND ST",
            "city": "RIO GRANDE CITY",
            "state": "TX",
            "postal_code": "785823803",
            "telephone_number": "956-488-1200",
            "fax_number": "956-488-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E 2ND ST",
            "city": "RIO GRANDE CITY",
            "state": "TX",
            "postal_code": "785823803",
            "telephone_number": "956-488-1200",
            "fax_number": "956-488-9500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "605 N Main St Ste B",
            "address_purpose": "LOCATION",
            "city": "Donna",
            "state": "TX",
            "postal_code": "785372726",
            "country_code": "US",
            "telephone_number": "956-464-4407",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 E Polk Ave",
            "address_purpose": "LOCATION",
            "city": "Pharr",
            "state": "TX",
            "postal_code": "785773110",
            "country_code": "US",
            "telephone_number": "956-781-6591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DORIA",
        "first_name": "OMAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-22",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA10542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Grande City, TX

Sources for this page

Verify at the official NPI Registry.