NPIMap

Individual provider Active NPI

Omar Ahmed Reda, MD

  • Psychiatry Physician
  • Fort Collins, CO
National Provider Identifier
1932328945
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
DR.0068792 Issued in CO
Practice address
4601 Corbett Dr
Fort Collins, CO 80528-9579
Phone
(970) 207-4857
Fax
(970) 207-4885
NPI assigned
Apr 25, 2007
Last updated
Dec 29, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD126132 OR
Psychiatry Physician 2084P0800X DR.0068792 CO Primary

Addresses

Primary practice location

4601 Corbett Dr
Fort Collins, CO 80528-9579

Mailing address

4601 Corbett Dr
Fort Collins, CO 80528-9579
Phone (970) 207-4857

Other practice location 1

9205 SW Barnes Rd
Portland, OR 97225-6603
Phone (503) 216-5102

Other practice location 2

2600 Center St NE
50D
Salem, OR 97301-2669
Phone (503) 945-2800

Other names 1

  • Omar Mohamed Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address oreda102772@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091110000285 OR Practitioner - Psychiatry 6002954153 Reassigns benefits to 1 organization
I20230308001061 CO Practitioner - Psychiatry 6002954153 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1024 S Lemay Ave
F1051 Heart and Vascular Fort Collins
Fort Collins, CO 80524-3929
Phone (970) 221-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0068792COMDPsychiatry Physician
MD126132ORMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Health Care, Inc CurrentSince Feb 27, 2023 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Sep 29, 2025 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Sep 29, 2025 Accepting new patients
Poudre Valley Health Care Inc. Current Accepting new patients
Poudre Valley Health Care Inc CurrentSince Feb 27, 2023 Accepting new patients
Providence Health & Services - Oregon PastSince Sep 8, 2014 Accepting new patients
Poudre Valley Health Care,Inc Past Accepting new patients

Locations

1024 S Lemay Ave
Fort Collins, CO 80524
Phone (970) 495-7000

1024 S Lemay Ave
#F1051
Fort Collins, CO 80524

1025 Pennock Pl
Fort Collins, CO 80524
Phone (970) 495-8800

4601 Corbett Dr
Fort Collins, CO 80528
Phone (970) 207-4800

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

Interoperability endpoints

  • Direct secure messaging: oreda102772@oc.providencedirect.org

Organizations & group practices 8

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1932328945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 CORBETT DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805289579",
            "telephone_number": "970-207-4857",
            "fax_number": "970-207-4885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 CORBETT DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805289579",
            "telephone_number": "970-207-4857",
            "fax_number": "970-207-4885"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9205 SW Barnes Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972256603",
            "country_code": "US",
            "telephone_number": "503-216-5102",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2600 Center St NE",
            "address_2": "50D",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973012669",
            "country_code": "US",
            "telephone_number": "503-945-2800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REDA",
        "first_name": "OMAR",
        "middle_name": "AHMED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "MD126132",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "DR.0068792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "oreda102772@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9205 SW Barnes Rd",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972256603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "OMAR",
            "last_name": "MOHAMED",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.