Maryam Omidi

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

025893 Issued in NY

Practice address

411 W 114TH St
New York, NY 10025-1710

Phone

(212) 523-6489

NPI assigned

Sep 12, 2022

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Icahn School of Medicine at Mount Sinai

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • New York, NY
  • NPI 1033482518
  Medicare reassignment NPD
• Icahn School of Medicine at Mount Sinai

  • Eyewear Supplier
  • New York, NY
  • NPI 1760227466
  NPD

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1659093243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 WEST 124TH STREET",
            "address_2": "FLOOR 7, ROOM 721",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10027",
            "telephone_number": "332-243-0075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 W 114TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251710",
            "telephone_number": "212-523-6489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMIDI",
        "first_name": "MARYAM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-12",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "025893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "maryam.omidi@mountsinai.org",
            "affiliation": "N",
            "endpointDescription": "Work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "NA",
            "address_1": "411 W 114th St",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100251710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mohamed O Omer
• Tariq Mohamed Omer, MD
• Bilal Omery, M.D.
• Omid Nikrouz MD PC
• Olamide Omidele
• Omidvari Psychiatry P.C.
• Mofaramoluwa Omilabu
• Omni Eye Surgery of New York
• Omni Eye Surgery of New York PC
• Omni Medical of Ny, PC

• Clinical Psychologist in New York, NY
• Providers in New York, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.