Individual provider Active NPI

Omar Farooq Mirza, D.O

  • Psychiatry Physician
  • Middletown, NY
National Provider Identifier
1619235538
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
283302 Issued in NY
Practice address
707 E Main St
Middletown, NY 10940-2650
Phone
(845) 333-7575
NPI assigned
Apr 28, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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 283302 NY Primary

Addresses

Primary practice location

707 E Main St
Middletown, NY 10940-2650

Mailing address

707 E Main St
Middletown, NY 10940-2650
Phone (845) 333-7575

Other practice location 1

68 Harris Bushville Rd
Harris, NY 12742
Phone (845) 333-8909

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address omirza77917@direct.garnethealth.org Direct Garnet Health Doctors PC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20170602002179 NY Practitioner - Psychiatry 2769759273 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Affiliate Group of New York PCGroup PAC ID 4688098833, 1,222 clinicians
Garnet Health Doctors PCGroup PAC ID 8628293545, 165 clinicians

Practice addresses (Care Compare)

506 Lenox Ave
New York, NY 10037-1802
Phone (212) 939-1840

707 E Main St
Middletown, NY 10940-2650
Phone (845) 333-7575

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Garnet Health Doctors PC CurrentSince Mar 1, 2026 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 1, 2017 Accepting new patients
Physician Affiliate Group of New York PC CurrentSince Mar 1, 2024 Accepting new patients
Garnet Health Doctors PC CurrentSince Mar 1, 2026 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 1, 2017 Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

75 Crystal Run Rd
Ste 135
Middletown, NY 10941
Phone (845) 333-7800

707 E Main St
Middletown, NY 10940
Phone (845) 333-1000

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

1425 Madison Ave
New York, NY 10029
Phone (212) 824-8150

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: omirza77917@direct.garnethealth.org
  • Direct secure messaging: omirza1054604@nychhc.direct-ci.com

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": "1335571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1619235538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 E MAIN ST",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402650",
            "telephone_number": "845-333-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 E MAIN ST",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402650",
            "telephone_number": "845-333-7575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "68 Harris Bushville Rd",
            "address_purpose": "LOCATION",
            "city": "Harris",
            "state": "NY",
            "postal_code": "12742",
            "country_code": "US",
            "telephone_number": "845-333-8909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRZA",
        "first_name": "OMAR",
        "middle_name": "FAROOQ",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-28",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "283302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "omirza77917@direct.garnethealth.org",
            "affiliation": "Y",
            "affiliationName": "Garnet Health Doctors PC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "707 E Main St",
            "city": "Middletown",
            "state": "NY",
            "country_code": "US",
            "postal_code": "109402650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

Verify at the official NPI Registry.