Derek Omori, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

3723 W 12600 S Ste 450
Riverton, UT 84065-7296

Phone

(801) 285-4673

NPI assigned

Sep 12, 2015

Last updated

Dec 24, 2023By the provider in NPPES

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

Enrolled in UT

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health Riverton Hospital Hospital, Riverton, UT, CCN 460058

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: derek.omori@1457.chartlogic.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment Care Compare group
• Ihc Health Services Inc

  dba South Sandy Clinic

  • Family Medicine Physician
  • Sandy, UT
  • NPI 1992830103
  NPD
• Ihc Health Services, Inc.

  dba St George Adolescent Partial Hospitalization

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Ihc Health Services Inc

  dba Orem Community Hospital Physicians

  • Multi-Specialty Clinic/Center
  • Orem, UT
  • NPI 1588601124
  NPD (past)
• Ihc Health Services Inc

  dba Orthopedic Specialty Group - Riverton Campus

  • Orthopaedic Surgery Physician
  • Riverton, UT
  • NPI 1952563579
  NPD (past)
• Overlake Internal Medicine Laboratory

  • Clinical Medical Laboratory
  • Bellevue, WA
  • NPI 1558422147
  NPD (past)

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

• Ihc Health Services Inc

  dba Intermountain Health Riverton Hospital

  • General Acute Care Hospital
  • Riverton, UT
  • NPI 1154551919
  Care Compare affiliation

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

{
    "created_epoch": "1442016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703376000000",
    "number": "1699143263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3723 W 12600 S STE 450",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840657296",
            "telephone_number": "801-285-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3723 W 12600 S STE 450",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840657296",
            "telephone_number": "801-285-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMORI",
        "first_name": "DEREK",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-12",
        "last_updated": "2023-12-24",
        "certification_date": "2023-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Siona Tutau Nuusila
• Rachel Kristina Nytch
• Teresa Oldham
• Jennifer Christine Oleskowicz, RN, APRN
• Brady D Olsen, LCSW
• Open Now Dental of Riverton
• Optimal Therapeutics LLC
• Oquirrh Mountain Counseling & Services LLC
• Orthoppedic Practice Associates
• Christina Marie Ortiz

• Physician Assistant in Riverton, UT
• Providers in Riverton, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 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.