Individual provider Active NPI

Omar Ferrari Jr., D.O.

  • Emergency Medicine Physician
  • Santa Rosa, CA
National Provider Identifier
1861589186
Registry record updated Dec 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20A12803 Issued in CA
Practice address
1165 Montgomery Dr
Santa Rosa, CA 95405-4897
Phone
(707) 980-3765
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 20A12803 CA Primary

Addresses

Primary practice location

1165 Montgomery Dr
Santa Rosa, CA 95405-4897

Mailing address

1165 Montgomery Dr
Santa Rosa, CA 95405-4897
Phone (707) 980-3765

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address oferrari1657691@oc.providencedirect.org

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130627000286 CA Practitioner - Emergency Medicine 8325068224 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1165 Montgomery Dr
Santa Rosa, CA 95405-4801
Phone (707) 546-3210

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A12803CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Apr 1, 2016 Accepting new patients
Providence Medical Foundation CurrentSince Apr 1, 2016 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Chase Dennis Emergency Medical Group Inc Emergency Medicine CurrentSince Jul 1, 2013 Accepting new patients
Tree Grove Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Providence Medical Foundation Past Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Harrison Lake Emergency Physicians Emergency Medicine Past Accepting new patients
Lucas County Emergency Physicians Inc Emergency Medicine Past Accepting new patients
Riverwood Emergency Services Inc. Emergency Medicine Past Accepting new patients

Locations

1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600

1621 W Imola Ave
Napa, CA 94559
Phone (707) 251-4280

1100 Trancas St
Ste 209
Napa, CA 94558
Phone (707) 251-1850

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

1165 Montgomery Dr
Santa Rosa, CA 95405
Phone (707) 525-5300

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

300 Hospital Dr
Vallejo, CA 94589
Phone (707) 554-4107

6580 Hembree Ln
Ste 270
Windsor, CA 95492
Phone (707) 838-2044

Interoperability endpoints

  • Direct secure messaging: oferrari1657691@oc.providencedirect.org

Organizations & group practices 10

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": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1861589186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 MONTGOMERY DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054897",
            "telephone_number": "707-980-3765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 MONTGOMERY DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054897",
            "telephone_number": "707-980-3765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERRARI",
        "first_name": "OMAR",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A12803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "oferrari1657691@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1165 Montgomery Dr",
            "city": "Santa Rosa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954054897",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.