NPIMap

Individual provider Active NPI

Omid Heravi

  • Hospitalist Physician
  • Brooklyn, NY
National Provider Identifier
1821523044
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
308685 Issued in NY
Practice address
150 55TH St
Brooklyn, NY 11220-2508
Phone
(718) 630-7000
NPI assigned
Apr 25, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 308685 NY Primary

Addresses

Primary practice location

150 55TH St
Brooklyn, NY 11220-2508

Mailing address

585 Schenectady Ave
K4
Brooklyn, NY 11203-1822
Phone (718) 363-6771

Other practice location 1

585 Schenectady Ave
K4
Brooklyn, NY 11203-1822
Phone (718) 363-6771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210223000579 NY Practitioner - Internal MedicinePractitioner - Hospitalist 7719392851 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interfaith Professional Physician Services PCGroup PAC ID 9931378171, 383 clinicians
University Physicians of Brooklyn, Inc.Group PAC ID 0749192284, 174 clinicians

Practice addresses (Care Compare)

1 Brookdale PLZ
Brooklyn, NY 11212-3198

1545 Atlantic Ave
Brooklyn, NY 11213-1122
Phone (718) 613-4000

450 Clarkson Ave
Brooklyn, NY 11203-2012
Phone (718) 826-4959

Hospital & facility affiliations

  • Brookdale Hospital Medical Center Hospital, Brooklyn, NY, CCN 330233
  • Maimonides Medical Center Hospital, Brooklyn, NY, CCN 330194
  • Suny/Downstate University Hospital of Brooklyn Hospital, Brooklyn, NY, CCN 330350

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
308685NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Feb 17, 2021 Accepting new patients
Brookdale Hospital Medical Center CurrentSince Jul 7, 2021 Accepting new patients
New York University CurrentSince Feb 17, 2021 Accepting new patients
Interfaith Professional Physician Services, P.C. CurrentSince Dec 4, 2023 Accepting new patients
The Brookdale Hospital Medical Center CurrentSince Jul 7, 2021 Accepting new patients
The Brookdale Hospital Medical Center Past Accepting new patients

Locations

1235 Linden Blvd
Fl 2
Brooklyn, NY 11212
Phone (718) 240-7143

1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175

1 Brookdale Plz
Brooklyn, NY 11212
Phone (718) 240-5212

585 Schenectady Ave
#K4
Brooklyn, NY 11203
Phone (718) 363-6771

150 55th St
Brooklyn, NY 11220
Phone (718) 630-7185

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1493078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1821523044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 SCHENECTADY AVE",
            "address_2": "K4",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031822",
            "telephone_number": "718-363-6771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 55TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112202508",
            "telephone_number": "718-630-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "585 Schenectady Ave",
            "address_2": "K4",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112031822",
            "country_code": "US",
            "telephone_number": "718-363-6771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERAVI",
        "first_name": "OMID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-25",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "308685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.