Active NPI
Omar Mubaidin, D.O.
- Hospitalist Physician
- Melbourne, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- OS12067
- Practice address
- 1350 Hickory St
Melbourne, FL 32901-3224 - Phone
- (321) 434-1771
- Fax
- (321) 434-1775
- NPI assigned
- Apr 4, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | OS12067 | FL | |
| Hospitalist Physician | 208M00000X | OS12067 | FL | Primary |
Addresses
Primary practice location
1350 Hickory St
Melbourne, FL 32901-3224
Mailing address
3300 S Fiske Blvd
Rockledge, FL 32955-4306
Phone (321) 434-1771
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LZ965 | Other | FL | MEDICARE |
| PENDING | Medicaid | FL | |
| PENDING | Other | FL | MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Hospitalist
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1350 Hickory St
Melbourne, FL 32901-3224
Phone (321) 434-7000
Hospital & facility affiliations
- Holmes Regional Medical Center
- Cape Canaveral Hospital
- Viera Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS12067 | FL | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MD Now Medical Centers Inc | Current | Accepting new patients | |
| MD Now Medical Centers Inc | Current | Accepting new patients | |
| Health First Medical Group, LLC | Current | Accepting new patients | |
| Accountable Care Hospitalist Group | Current | Accepting new patients | |
| West Palm Beach Physician Group Inc | Hospitalist | Current | Accepting new patients |
| Health First Medical Group, LLC | Family Medicine | Current | Accepting new patients |
Locations
800 Meadows Rd
Boca Raton, FL 33486
Phone (561) 395-7100
699 W Cocoa Beach Cswy
Ste 405
Cocoa Beach, FL 32931
Phone (321) 868-7272
1210 S Old Dixie Hwy
Jupiter, FL 33458
Phone (561) 743-5073
4570 Lantana Rd
Lake Worth, FL 33463
Phone (305) 949-4141
1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-1771
3300 S Fiske Blvd
Rockledge, FL 32955
Phone (321) 434-1771
1155 S Congress Ave
Ste C
West Palm Beach, FL 33406
Phone 5617661300601
3461 Fairlane Farms Rd
West Palm Beach, FL 33414
Phone 56176613001109
9060 N Military Trl
West Palm Beach, FL 33410
Phone (561) 295-8822
13001 State Road 80
Westlake, FL 33470
Phone (561) 793-3300
Interoperability endpoints
- omubaidin27593@epicdirect.hf.org
Organizations & group practices 6
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.
-
- General Practice Physician
- Melbourne, FL
- NPI 1750626495
Family Medicine, FL
-
- Hospitalist Physician
- Boca Raton, FL
- NPI 1235231465
FL, Hospitalist
-
- General Practice Physician
- Rockledge, FL
- NPI 1073268934
-
- Urgent Care Clinic/Center
- Pembroke Pines, FL
- NPI 1265107361
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Melbourne, FL
- NPI 1295702728
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585094400000",
"number": "1710220140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3300 S FISKE BLVD",
"city": "ROCKLEDGE",
"state": "FL",
"postal_code": "329554306",
"telephone_number": "321-434-1771",
"fax_number": "321-434-1775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 HICKORY ST",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329013224",
"telephone_number": "321-434-1771",
"fax_number": "321-434-1775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUBAIDIN",
"first_name": "OMAR",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-04-04",
"last_updated": "2020-03-25",
"certification_date": "2020-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "OS12067",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "FL",
"license": "OS12067",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "LZ965",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "PENDING",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; 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.