Organization Active NPI

Joseph a Oommen MD PLLC

  • Neurology Physician
  • Beaumont, TX
National Provider Identifier
1568755544
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
M7491 Issued in TX
Legal business name
JOSEPH A OOMMEN MD PLLC
Practice address
3560 Delaware St Ste 1104
Beaumont, TX 77706-3000
Phone
(409) 347-8870
NPI assigned
May 24, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Authorized official

Name
Dr. Joseph Anthony Oommen, M.D.NPI 1770518516
Title
Medical Director
Phone
(409) 347-8870

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X M7491 TX Primary
Clinical Neurophysiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0600X M7491 TX
Sleep Medicine (Psychiatry & Neurology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084S0012X M7491 TX

Addresses

Primary practice location

3560 Delaware St Ste 1104
Beaumont, TX 77706-3000

Mailing address

3560 Delaware St Ste 1104
Beaumont, TX 77706-3000
Phone (409) 347-8870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110826000041 TX Part B Supplier - Clinic/Group Practice 1052581279 Receives reassigned benefits from 1 practitioner
Practice locations: Beaumont, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2040210Joseph a Oommen MD PLLC3560 Delaware, Suite 1104, Beaumont, TX 77706Certificate of waiverApr 24, 2028

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GHHEBA

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1306195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662940800000",
    "number": "1568755544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3560 DELAWARE ST STE 1104",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777063000",
            "telephone_number": "409-347-8870",
            "fax_number": "409-347-8878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3560 DELAWARE ST STE 1104",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777063000",
            "telephone_number": "409-347-8870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH A OOMMEN MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-24",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A",
        "authorized_official_last_name": "OOMMEN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "409-347-8870",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "M7491",
            "primary": true
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "TX",
            "license": "M7491",
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "TX",
            "license": "M7491",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.