Omondi Nyongo, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

A98323 Issued in CA

Practice address

3130 Alpine Rd Ste 200
Portola Valley, CA 94028-7521

Phone

(650) 850-5323

NPI assigned

Jul 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2024 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: onyongo7445@hisp.ehr.sutterhealth.org
• Direct secure messaging: omondi.nyongo@302934149496836.direct.elationemr.com

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.

• LPCH Medical Group Div of Lucile

  • Children's Hospital
  • Palo Alto, CA
  • NPI 1417907940
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1629099015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 ALPINE RD STE 200",
            "city": "PORTOLA VALLEY",
            "state": "CA",
            "postal_code": "940287521",
            "telephone_number": "650-850-5323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 ALPINE RD STE 200",
            "city": "PORTOLA VALLEY",
            "state": "CA",
            "postal_code": "940287521",
            "telephone_number": "650-850-5323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3130 Alpine Rd Ste 180",
            "address_purpose": "LOCATION",
            "city": "Portola Valley",
            "state": "CA",
            "postal_code": "940287521",
            "country_code": "US",
            "telephone_number": "650-850-5323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NYONGO",
        "first_name": "OMONDI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2024-05-20",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A98323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Marie Mittelstadt, LAC
• John Kurt Moore, D.C.
• Maxwell Moore, DC
• Emma C Morton-Bours, M.D.
• Jane Abeel Morton, M.D.
• Gregory Ohanessian, PT, DPT
• Katherine Ohanlan, M.D.
• Crista Osio, PT, MSPT
• Pacific Therx
• Pacific Therx, Inc.

• Ophthalmology Physician in Portola Valley, CA
• Providers in Portola Valley, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.