Osman Omar Atiq, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

E-14140 Issued in AR

Practice address

11234 Anderson St Dept of
Loma Linda, CA 92354-2804

Phone

(909) 558-4000

NPI assigned

Apr 2, 2019

Reactivated

Aug 4, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ, AR2 enrollments

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 2

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 and National Provider Directory roles.

• Arkansas Post Discharge Services, PLLC

  • Hospitalist Physician
  • Fort Smith, AR
  • NPI 1851152029
  Medicare reassignment NPD
• Cogent Healthcare of Arizona PC

  • Internal Medicine Physician
  • Sierra Vista, AZ
  • NPI 1568758266
  Medicare reassignment NPD
• Sebastian Physician Services, PLLC

  • Hospitalist Physician
  • Fort Smith, AR
  • NPI 1255110110
  Medicare reassignment NPD

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

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1720540347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 E DATE PALM PASEO APT 2018",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917647625",
            "telephone_number": "870-718-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST DEPT OF",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATIQ",
        "first_name": "OSMAN",
        "middle_name": "OMAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-02",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "deactivation_date": "2022-06-27",
        "reactivation_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A179232",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "A179232",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A179232",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-14140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "233001795",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Isabel Aste, DO
• Juan Andres Astudillo-Cordova, M.D.
• Kettlen Cristh Ataides Borda
• Syed Ahmed Athar, M.D.
• Corinne Atiga, DDS
• Philopatir Joseph Attalla, MD
• Abraam Attia
• Michelle L Ault, RN
• Rita Auro, MD
• Lorene Joy Ausman, NP

• Internal Medicine Physician in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.