Individual provider Active NPI

Omar Medhat Ragab, M.D.

  • Radiation Oncology Physician
  • Los Angeles, CA
National Provider Identifier
1578880670
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
A121003 Issued in CA
Practice address
1441 Eastlake Ave
Los Angeles, CA 90089-0112
Phone
(323) 865-3050
NPI assigned
Apr 28, 2010
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X A121003 CA Primary

Addresses

Primary practice location

1441 Eastlake Ave
Los Angeles, CA 90089-0112

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 865-3050

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address omar.ragab@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150721003333 CA Practitioner - Radiation Oncology 7214240126 Reassigns benefits to 1 organization
I20231109002969 NY Practitioner - Radiation Oncology 7214240126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of Southern California Keck School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Mary's HealthcareGroup PAC ID 7618960709, 114 clinicians

Practice addresses (Care Compare)

4950 State Hwy 30
Amsterdam, NY 12010-7520
Phone (518) 541-3600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A121003CAMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Aug 6, 2016 Accepting new patients
St Marys Healthcare CurrentSince Oct 1, 2023 Accepting new patients
St. Mary's Healthcare CurrentSince Oct 1, 2023 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Aug 6, 2016 Accepting new patients
St. Mary's Healthcare Past Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients
Keck Medical Center of Usc Past Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients

Locations

1441 Eastlake Ave
Los Angeles, CA 90089
Phone (323) 865-3000

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

380 Guy Park Ave
Amsterdam, NY 12010
Phone (518) 841-7415

427 Guy Park Ave
Amsterdam, NY 12010
Phone (518) 442-1404

4950 State Highway 30
Amsterdam, NY 12010
Phone (518) 770-7557

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: omar.ragab@direct.usc.edu

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1272412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1578880670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-865-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 EASTLAKE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900890112",
            "telephone_number": "323-865-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGAB",
        "first_name": "OMAR",
        "middle_name": "MEDHAT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-28",
        "last_updated": "2023-11-27",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "A121003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "omar.ragab@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1441 Eastlake Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900890112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.