Individual provider Active NPI

Omar Nesheiwat, MD

  • Epilepsy Physician
  • Thousand Oaks, CA
National Provider Identifier
1730683350
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Epilepsy PhysicianTaxonomy code 2084E0001X
License
A174804 Issued in CA
Practice address
2190 Lynn Rd Ste 380
Thousand Oaks, CA 91360-8029
Phone
(805) 242-4884
Fax
(805) 242-4885
NPI assigned
Mar 19, 2018
Last updated
Feb 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Epilepsy Physician 2084E0001X A174804 CA Primary

Addresses

Primary practice location

2190 Lynn Rd Ste 380
Thousand Oaks, CA 91360-8029

Mailing address

2190 Lynn Rd Ste 380
Thousand Oaks, CA 91360-8029
Phone (805) 242-4884

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20230928002496 CA Practitioner - Neurology 9931580289 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of California, Irvine, California College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vascular Neurology of Southern California IncGroup PAC ID 0143558643, 8 clinicians

Practice addresses (Care Compare)

2190 Lynn Rd
Suite 300
Thousand Oaks, CA 91360-8024
Phone (805) 242-4884

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A174804CAMDEpilepsy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vascular Neurology of Southern California Inc CurrentSince Aug 16, 2023 Accepting new patients

Locations

2190 Lynn Rd
Ste 300
Thousand Oaks, CA 91360
Phone (805) 242-4884

2190 Lynn Rd
Ste 380
Thousand Oaks, CA 91360
Phone (805) 242-4884

Interoperability endpoints

  • Direct secure messaging: omar.nesheiwat@200733209001988.direct.elationemr.com

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1730683350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2190 LYNN RD STE 380",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913608029",
            "telephone_number": "805-242-4884",
            "fax_number": "805-242-4885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2190 LYNN RD STE 380",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913608029",
            "telephone_number": "805-242-4884",
            "fax_number": "805-242-4885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NESHEIWAT",
        "first_name": "OMAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-19",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084E0001X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Epilepsy",
            "state": "CA",
            "license": "A174804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

Verify at the official NPI Registry.