Individual provider Active NPI

Omar Nihad Al-Masri, MD

  • Pediatric Nephrology Physician
  • Marshfield, WI
National Provider Identifier
1770212433
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
82344 Issued in WI
Practice address
1000 N Oak Ave
Marshfield, WI 54449-5702
Phone
(715) 387-5511
NPI assigned
Jun 8, 2022
Last updated
Aug 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A68546 CA
Pediatric Nephrology Physician 2080P0210X 82344 WI Primary

Addresses

Primary practice location

1000 N Oak Ave
Marshfield, WI 54449-5702

Mailing address

1000 N Oak Ave
Marshfield, WI 54449-5702
Phone (715) 221-5770

Other practice location 1

Karama Street
Sheikh Khalifa Medical City
Abu Dhabi, UAE 767107
AE
Phone (515) 520-3094 ext. 2047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20230823004023 WI Practitioner - Pediatric MedicinePractitioner - Nephrology 1052774064 Reassigns benefits to 9 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A68546CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Medical Center Inc of Rice Lake Pediatrics CurrentSince Aug 14, 2023 Accepting new patients
MCHS Hospitals Inc CurrentSince Aug 14, 2023 Accepting new patients
Flambeau Hospital Inc Current Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Aug 14, 2023 Accepting new patients
Memorial Hospital Inc CurrentSince Aug 14, 2023 Accepting new patients
MCHS Hospitals Inc CurrentSince Aug 14, 2023 Accepting new patients
Flambeau Hospital Inc CurrentSince Aug 14, 2023 Accepting new patients
Marshfield Clinic Inc CurrentSince Aug 14, 2023 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Aug 14, 2023 Accepting new patients
Memorial Hospital Inc Past Accepting new patients

Locations

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1770212433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495702",
            "telephone_number": "715-221-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495702",
            "telephone_number": "715-387-5511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "KARAMA STREET",
            "address_2": "SHEIKH KHALIFA MEDICAL CITY",
            "address_purpose": "LOCATION",
            "city": "ABU DHABI",
            "state": "UAE",
            "postal_code": "767107",
            "country_code": "AE",
            "telephone_number": "515-520-3094 x2047",
            "country_name": "United Arab Emirates",
            "address_type": "FGN"
        }
    ],
    "basic": {
        "last_name": "AL-MASRI",
        "first_name": "OMAR",
        "middle_name": "NIHAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-08",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A68546",
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "WI",
            "license": "82344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshfield, WI

Sources for this page

Verify at the official NPI Registry.