Jacob Saj Oommen, M.D

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

04-25365 Issued in KS

Practice address

19204 N 93Rd Way
Scottsdale, AZ 85255-5528

Phone

(480) 821-9339

Fax

(480) 821-9555

NPI assigned

Jun 10, 2006

Last updated

May 20, 2008By 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 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ

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

Infectious Disease

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Synergy Infectious DiseaseGroup PAC ID 9830361682, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Victory Home Care Agency Home health agency, Mesa, AZ, CCN 037230
• American Home Health Services, Inc. Home health agency, Mesa, AZ, CCN 037426
• Banner Gateway Medical Center Hospital, Gilbert, AZ, CCN 030122
• Banner Ocotillo Medical Center Hospital, Chandler, AZ, CCN 030147
• Mercy Gilbert Medical Center Hospital, Gilbert, AZ, CCN 030119
• Banner Thunderbird Medical Center Hospital, Glendale, AZ, CCN 030089

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Synergy Infectious Disease

  • Infectious Disease Physician
  • Chandler, AZ
  • NPI 1609157197
  Medicare reassignment Care Compare group NPD Authorized official
• Phoenix Id LLC

  • Infectious Disease Physician
  • Phoenix, AZ
  • NPI 1205027646
  NPD (past) Authorized official

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

• American Home Health Services, Inc

  • Home Health Agency
  • Mesa, AZ
  • NPI 1114279536
  Care Compare affiliation
• Banner Gateway Medical Center

  • General Acute Care Hospital
  • Gilbert, AZ
  • NPI 1699884858
  Care Compare affiliation
• Banner Health

  dba Banner Ocotillo Medical Center

  • General Acute Care Hospital
  • Chandler, AZ
  • NPI 1972139004
  Care Compare affiliation
• Banner Thunderbird Medical Center

  • General Acute Care Hospital
  • Glendale, AZ
  • NPI 1154355188
  Care Compare affiliation
• Dignity Health

  dba Mercy Gilbert Medical Center

  • General Acute Care Hospital
  • Gilbert, AZ
  • NPI 1992735088
  Care Compare affiliation
• Villaraza Corporation

  dba DBA: Victory Home Care Agency

  • Home Health Agency
  • Mesa, AZ
  • NPI 1972505881
  Care Compare affiliation

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1720020431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19204 N 93RD WAY",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852555528",
            "telephone_number": "480-280-7007",
            "fax_number": "480-821-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19204 N 93RD WAY",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852555528",
            "telephone_number": "480-821-9339",
            "fax_number": "480-821-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OOMMEN",
        "first_name": "JACOB",
        "middle_name": "SAJ",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "KS",
            "license": "04-25365",
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MO",
            "license": "112403",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IL",
            "license": "036-087704",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "AZ",
            "license": "37316",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "240491",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "37316",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark K Ono, MD
• Kelly Catherine Ontiveros, LICENSED MARRIAGE &
• Leticia Ontiveros, RDH
• Onward True PLLC
• Nelson O Onyango, MD
• Rosemary Ifeyinwa Opara
• Open Mind Group LLC
• John C Opie, MD
• Donald A. Opila, M.D.
• Optics of Scottsdale LLC

• Infectious Disease Physician in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Infectious Disease Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.