Individual provider Active NPI

Omar Ali, MBBCH

  • Nephrology Physician
  • Philadelphia, PA
National Provider Identifier
1942989777
Registry record updated May 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MT237503 Issued in PA
Practice address
3401 N Broad St
Philadelphia, PA 19140-5103
Phone
(215) 707-3829
NPI assigned
Jul 18, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MT237503 PA Primary
Student in an Organized Health Care Education/Training Program 390200000X PA

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140-5103

Mailing address

3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-3829

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20260608001485 PA Order and Referring Only - NephrologyPractitioner - Internal MedicinePractitioner - Nephrology 2163993411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MT237503PAMDNephrology Physician

NPI Registry JSON

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

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780099200000",
    "number": "1942989777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-3829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-3829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI",
        "first_name": "OMAR",
        "name_prefix": "Dr.",
        "credential": "MBBCH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-18",
        "last_updated": "2026-05-30",
        "certification_date": "2026-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "MT237503",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.