Mennatallah Omar, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

35144594 Issued in OH

Practice address

501 Van Buren St Ste 203
Fostoria, OH 44830-1593

Phone

(419) 355-8488

Fax

(419) 355-8490

NPI assigned

Jun 28, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

General Surgery

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Memorial Professional Services LTDGroup PAC ID 1456531870, 40 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital Hospital, Fremont, OH, CCN 360156
• Fostoria Community Hospital Hospital, Fostoria, OH, CCN 361318
• Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: momar13334@direct.promedica.org

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.

• Memorial Professional Services LTD

  • Pulmonary Disease Physician
  • Fremont, OH
  • NPI 1205139623
  Medicare reassignment Care Compare group NPD
• Promedica Central Physicians

  • Family Medicine Physician
  • Toledo, OH
  • NPI 1043270150
  Medicare reassignment Care Compare group

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

• Fostoria Hospital Association

  • Critical Access Hospital
  • Fostoria, OH
  • NPI 1275533226
  Care Compare affiliation
• Memorial Hospital

  • General Acute Care Hospital
  • Fremont, OH
  • NPI 1851338149
  Care Compare affiliation
• The Toledo Hospital

  • General Acute Care Hospital
  • Toledo, OH
  • NPI 1407854771
  Care Compare affiliation
• Toledo Hospital

  • Ambulance
  • Toledo, OH
  • NPI 1427147339

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1435449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1619359551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2281 HAYES AVE",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434202632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 VAN BUREN ST STE 203",
            "city": "FOSTORIA",
            "state": "OH",
            "postal_code": "448301593",
            "telephone_number": "419-355-8488",
            "fax_number": "419-355-8490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2281 Hayes Ave",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "OH",
            "postal_code": "434202632",
            "country_code": "US",
            "telephone_number": "419-355-8488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OMAR",
        "first_name": "MENNATALLAH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-28",
        "last_updated": "2023-11-03",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35144594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0498909",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "momar13334@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cierra Desirrae Norman
• North Central Family Health Center Inc
• Hannah English North, PHARMD
• Cynthia Nye
• Sara Ann Oberhaus, STNA
• Hannah Joy Overmyer, PTA
• Casandra Rae Parrish
• Bennett J Paulus, OD
• Sharon Perez
• Pharmacy Counter, LLC

• Surgery Physician in Fostoria, OH
• Providers in Fostoria, OH by specialty
• Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.