NPIMap

Organization Active NPI

Omnj Division Three LLC

  • Anesthesiology Physician
  • New York, NY
National Provider Identifier
1780498196
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
OMNJ DIVISION THREE LLC
Practice address
694 Main St # 257
New York, NY 10044-0027
Phone
(718) 255-6391
Fax
(718) 255-6392
NPI assigned
Feb 5, 2025
Last updated
Feb 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Authorized official

Name
Harshvardhan Chaobal, DONPI 1558401679
Title
Owner
Phone
(718) 255-6391

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

694 Main St # 257
New York, NY 10044-0027

Mailing address

694 Main St # 257
New York, NY 10044-0027
Phone (718) 255-6391

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250624000216 NJ Part B Supplier - Clinic/Group Practice 6608388939 Receives reassigned benefits from 21 practitioners
Practice locations: Lawrence Township, NJ; Trenton, NJ

National Provider Directory

National Provider Directory

Locations

1700 Whitehorse Hamilton Square Rd
Ste A1
Trenton, NJ 08690
Phone (215) 781-2020

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1738713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738713600000",
    "number": "1780498196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "694 MAIN ST # 257",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100440027",
            "telephone_number": "718-255-6391",
            "fax_number": "718-255-6392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "694 MAIN ST # 257",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100440027",
            "telephone_number": "718-255-6391",
            "fax_number": "718-255-6392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNJ DIVISION THREE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-05",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A",
        "authorized_official_last_name": "CHAOBAL",
        "authorized_official_first_name": "HARSHVARDHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-255-6391",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.