Omer Khalique Tipu, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

252322 Issued in NY

Practice address

446 McDonald Ave
Brooklyn, NY 11218-2212

Phone

(718) 972-4200

Fax

(718) 972-6861

NPI assigned

Jul 7, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Family PracticeAlso: Geriatric Medicine

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

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.

• Omer Tipu Physician PC

  • Geriatric Medicine (Family Medicine) Physician
  • Brooklyn, NY
  • NPI 1780004358
  Medicare reassignment NPD Authorized official
• Abdul Malik Physician PC

  • Health Service Clinic/Center
  • Dix Hills, NY
  • NPI 1699901561
  NPD (past)
• American Comprehensive Healthcare Medical Group PC

  • Specialist
  • Brooklyn, NY
  • NPI 1780908863
  NPD (past)

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

{
    "created_epoch": "1246924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1669601159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 MCDONALD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112182212",
            "telephone_number": "718-972-4200",
            "fax_number": "718-972-6861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 MCDONALD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112182212",
            "telephone_number": "718-972-4200",
            "fax_number": "718-972-6861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIPU",
        "first_name": "OMER",
        "middle_name": "KHALIQUE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-07",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "252322",
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "252322",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03278764",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tinytree O.T, PC
• Ruy Chen Tio, D.O.
• Tip Top Speech & Language Therapy
• Allison Tipaldo
• Thomas Tippy, PT, DPT
• Tipul Medical P.C.
• Paula Gaviota Tirado-Mansilla, LCSW
• Alexis Tirado
• Gladys Tirado, CASAC
• Michal Sarit Tirado, M.A., MHC-LP

• Family Medicine Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.
• 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.