Omead Mirgoli, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A195169 Issued in CA

Practice address

7600 River Rd
North Bergen, NJ 07047-6217

Phone

(201) 854-5000

NPI assigned

Mar 24, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Via Care Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1497001226
  Medicare reassignment
• Via Care Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1730630997
  NPD

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

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1821625609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5762 FAIRHAVEN AVE",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913673927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 RIVER RD",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070476217",
            "telephone_number": "201-854-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRGOLI",
        "first_name": "OMEAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-24",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A195169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edith Tortora Micale, PHARM.D
• Paul W Millhouse, MD
• Geehee Min, RPH
• Daniel Kyung Minn, MD
• Frank Mirabelli, M.A.
• Cynthia Mofunanya
• Ahmed Salaheldin Mohamed, MD
• Jack Laurence Moi, DO
• Alex A Molina, MD
• Vernisse Diana Molina

• Family Medicine Physician in North Bergen, NJ
• Providers in North Bergen, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.