Individual provider Active NPI

Omar Mohamed, DO

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1790304962
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
323863 Issued in NY
Practice address
260 Avenue X
Brooklyn, NY 11223-5940
Phone
(718) 522-3399
NPI assigned
Apr 8, 2020
Last updated
Aug 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 323863 NY Primary
Internal Medicine Physician 207R00000X 25MB11973800 NJ

Addresses

Primary practice location

260 Avenue X
Brooklyn, NY 11223-5940

Mailing address

6411 136TH St
Flushing, NY 11367-1114

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 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

Enrollment IDStateProvider typePAC IDDetails
I20240208003283 NJ Practitioner - Internal Medicine 6305289125 Reassigns benefits to 1 organization
I20260513001835 NY Practitioner - Internal Medicine 6305289125 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rwjbh Emergency Medicine Associates, LLCGroup PAC ID 0941612840, 826 clinicians

Practice addresses (Care Compare)

94 Old Short Hills Rd
Livingston, NJ 07039-5672
Phone (973) 322-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB11973800NJMDInternal Medicine Physician
323863NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Century Medical & Dental Center Inc CurrentSince Dec 18, 2002 Accepting new patients
Rwjbh Emergency Medicine Associates, LLC Internal Medicine CurrentSince Dec 10, 2023 Accepting new patients

Locations

225 Williamson St
Elizabeth, NJ 07202
Phone (908) 994-5204

600 River Ave
Lakewood, NJ 08701
Phone (732) 363-1900

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545

200 Livingston St
Brooklyn, NY 11201
Phone (718) 522-3399

260 Avenue X
Brooklyn, NY 11223
Phone (718) 336-8855

827 11th Ave
New York, NY 10019
Phone (212) 257-9778

Organizations & group practices 6

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 1

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": "1586304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1790304962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6411 136TH ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113671114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 AVENUE X",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112235940",
            "telephone_number": "718-522-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMED",
        "first_name": "OMAR",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-08",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "323863",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB11973800",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.