David X Omara DPM PC
Organization Active NPI Foot & Ankle Surgery Podiatrist · Mahopac, NY
NPI 1861680779 · NPPES record last updated Dec 2, 2014
Key facts
- NPI
- 1861680779
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Foot & Ankle Surgery Podiatrist 213ES0103X
- License
- N004787 (NY)
- Legal business name
- DAVID X OMARA DPM PC
- Practice address
- 21 Clark PL
Mahopac, NY 10541-4723 - Phone
- (845) 628-7400
- Fax
- (845) 628-7442
- NPI assigned
- Oct 5, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. David X Omara, DPM
- Title
- President
- Phone
- (845) 628-7400
Practitioners 1
-
David X. O'Mara, DPM
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060224000678 | NY | Part B Supplier - Clinic/Group Practice | 9638185846 |
Receives reassigned benefits from 1 practitioner Practice locations: Mahopac, NY |
National Provider Directory
Locations
21 Clark Pl
Ste 2
Mahopac, NY 10541
Phone (845) 628-7400
21 Clark Pl
Mahopac, NY 10541
Phone (845) 621-2211
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist |
213ES0103X | N004787 | NY | Yes |
Addresses
Primary practice location
21 Clark PL
Mahopac, NY 10541-4723
Mailing address
21 Clark PL
2ND Floor
Mahopac, NY 10541-4723
Phone (845) 628-7400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861680779 | Other | NY | NPI |
Other providers in Mahopac, NY
- Nicole Cuomo
- CVS Albany LLC
- Kaitlyn Daly
- Lisa Danielli-Pease
- Shaun Frederick Darrah
- Lorelei Davidson
- Tracy Deady
- Cristin Gloria Deagan
- Jodi Christine Deans
- Gionna Mishel Decola
All providers in Mahopac, NY · Foot & Ankle Surgery Podiatrist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 2, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.