Active NPI
Karan Omidvari, MD
- Critical Care Medicine (Internal Medicine) Physician
- Hackensack, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine (Internal Medicine) Physician
- License
- 139772
- Practice address
- 385 Prospect Ave Ste 204
Hackensack, NJ 07601-2570 - Phone
- (551) 996-9190
- NPI assigned
- Feb 6, 2006
- Last updated
- Jan 7, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 219979 | NY | |
| Pulmonary Disease Physician | 207RP1001X | 219979 | NY | |
| Hospitalist Physician | 208M00000X | 219979 | NY | |
| Hospitalist Physician | 208M00000X | MA56381 | NJ | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 139772 | NJ | Primary |
Addresses
Primary practice location
385 Prospect Ave Ste 204
Hackensack, NJ 07601-2570
Mailing address
170 E 87TH St Apt W11A
New York, NY 10128-2238
Phone (201) 967-8425
Other practice location 1
17 Elm Ave Fl 3
Hackensack, NJ 07601-4702
Phone (201) 967-8425
Other practice location 2
30 Prospect Ave
Critical Care Unit
Hackensack, NJ 07601-1915
Phone (551) 996-3500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 80187 | Medicaid | NJ | |
| 25MA05638100 | Other | NJ | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Critical Care (Intensivists)
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
30 Prospect Ave
Hackensack, NJ 07601-1915
Phone (551) 996-5045
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.78 of 100
- Quality
- 94.47
- Improvement activities
- 0
- Cost
- 80.32
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 139772 | NJ | MD | Critical Care Medicine (Internal Medicine) Physician |
| 219979 | NY | MD | Pulmonary Disease Physician |
| MA56381 | NJ | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hackensack Meridian Health Medical Group - Specialty Care PC | Current | Accepting new patients | |
| Hackensack Meridian Health Medical Group - Specialty Care PC | Internal Medicine | Current | Accepting new patients |
| Cathedral Physician Services, P.C. | Past | Accepting new patients | |
| Lsu Medical Center | Past | Accepting new patients | |
| Park Lenox Medical, PC | Internal Medicine | Past | Accepting new patients |
| Dac Physician Services,PC | Internal Medicine | Past | Accepting new patients |
| Louisiana State University School of Medicine in New Orleans Faculty G | Past | Accepting new patients |
Locations
385 Prospect Ave
Ste 204
Hackensack, NJ 07601
Phone (551) 996-9140
30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066
20 Prospect Ave
Ste 615
Hackensack, NJ 07601
Phone (201) 996-0308
111 Central Ave
Newark, NJ 07102
Phone (973) 877-5060
130 Kinderkamack Rd
Ste 203
River Edge, NJ 07661
Phone (201) 343-4910
Interoperability endpoints
- karan.omidvari@direct.hackensackmeridian.org
- https://fhir4.healow.com/fhir/r4/IHJHBD
Organizations & group practices 9
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.
-
dba HMHMG Specialty Care
- Surgical Critical Care Physician
- Red Bank, NJ
- NPI 1215989249
Internal Medicine
-
dba NHPP Cardiology at Great Neck
- Urology Physician
- Great Neck, NY
- NPI 1053688572
-
- Critical Care Medicine (Internal Medicine) Physician
- Hackensack, NJ
- NPI 1538706825
-
dba HMMG New Jersey Oral & Maxillofacial Surgery
- Durable Medical Equipment & Medical Supplies
- North Bergen, NJ
- NPI 1215734199
-
- Specialist
- Newark, NJ
- NPI 1720032964
-
- Physical Medicine & Rehabilitation Physician
- New York, NY
- NPI 1083732663
Internal Medicine
-
dba LSU Healthcare Network
- Multi-Specialty Clinic/Center
- New Orleans, LA
- NPI 1477582526
-
- Speech-Language Pathologist
- New Orleans, LA
- NPI 1588737803
-
- Internal Medicine Physician
- New York, NY
- NPI 1043386071
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Hackensack University Medical Center
- General Acute Care Hospital
- Hackensack, NJ
- NPI 1457456279
-
dba Hackensack Meridian Diagnostic Laboratory
- Clinical Medical Laboratory
- Hackensack, NJ
- NPI 1518683929
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578355200000",
"number": "1962474742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "170 E 87TH ST APT W11A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101282238",
"telephone_number": "201-967-8425",
"fax_number": "201-263-4665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "385 PROSPECT AVE STE 204",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "076012570",
"telephone_number": "551-996-9190"
}
],
"practiceLocations": [
{
"address_1": "17 Elm Ave Fl 3",
"address_purpose": "LOCATION",
"city": "Hackensack",
"state": "NJ",
"postal_code": "076014702",
"country_code": "US",
"telephone_number": "201-967-8425",
"fax_number": "201-263-4665",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "30 Prospect Ave",
"address_2": "Critical Care Unit",
"address_purpose": "LOCATION",
"city": "Hackensack",
"state": "NJ",
"postal_code": "076011915",
"country_code": "US",
"telephone_number": "551-996-3500",
"fax_number": "551-996-3298",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OMIDVARI",
"first_name": "KARAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-06",
"last_updated": "2020-01-07",
"certification_date": "2020-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "219979",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "NY",
"license": "219979",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "NY",
"license": "219979",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "NJ",
"license": "MA56381",
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "NJ",
"license": "139772",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "80187",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "25MA05638100",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hackensack, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.