Omar Alazem, DO
Individual provider Active NPI Emergency Medicine Physician · Davenport, IA
NPI 1780320697 · NPPES record last updated Sep 2, 2025
Key facts
- NPI
- 1780320697
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- DO-07009 (IA)
- Practice address
- 1227 E Rusholme St
Davenport, IA 52803-2459 - Phone
- (563) 421-1000
- Fax
- (510) 250-0843
- NPI assigned
- May 12, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Michigan State University College of Osteopathic Medicine, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Vituity-Iowa PLLC
Practice addresses (Care Compare)
1227 E Rusholme St
Davenport, IA 52803-2459
Phone (563) 421-1000
Hospital & facility affiliations
- Genesis Medical Center-Davenport
- Sacred Heart Hospital
- Sacred Heart Hospital on the Emerald Coast
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IA, FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250910002726 | IA | Practitioner - Emergency Medicine | 8820477318 | Reassigns benefits to 1 organization |
| I20260427003530 | FL | Practitioner - Emergency Medicine | 8820477318 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO-07009 | IA | MD | Emergency Medicine Physician |
| 036.174423 | IL | MD | Emergency Medicine Physician |
| 02008346A | IN | MD | Emergency Medicine Physician |
| 336158 | NY | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vituity-Iowa PLLC | Emergency Medicine | Current |
Accepting new patients |
| Vituity-Iowa PLLC | Emergency Medicine | Current |
Accepting new patients |
Locations
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
2140 53rd Ave
Bettendorf, IA 52722
Phone (563) 421-5700
1227 E Rusholme St
Davenport, IA 52803
Phone (563) 324-8160
Interoperability endpoints
- oalazem733881@direct.hfhs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 5151015708 | MI | |
| Emergency Medicine Physician | 207P00000X | 02008346A | IN | |
| Emergency Medicine Physician | 207P00000X | 036.174423 | IL | |
| Emergency Medicine Physician | 207P00000X | 336158 | NY | |
| Emergency Medicine Physician | 207P00000X | DO-07009 | IA | Yes |
Addresses
Primary practice location
1227 E Rusholme St
Davenport, IA 52803-2459
Mailing address
1601 Cummins Dr Ste D
Modesto, CA 95358-6411
Other practice location 1
28050 Grand River Ave
Farmington Hills, MI 48336-5919
Phone (947) 521-8566
Other providers in Davenport, IA
- Mahtab Uddin Ahmed
- Gaurav Ahuja
- Cheyenne Nicole Ailiff
- Mouhamed Walid Al Sheikha
- Alan D. Hathaway D.D.S. P.C.
- Morgan Alber
- Kelly Albertson
- Brian Eugene Albery
- Sarah Elizabeth Albrecht
- Alcohol & Drug Dependency Services
All providers in Davenport, IA · Emergency Medicine Physician in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 2, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.