NPIMap

Individual provider Active NPI

Robert Omwoyo Omuria, MD

  • Internal Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1962696856
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101251839 Issued in VA
Practice address
2525 E Camelback Rd
1100
Phoenix, AZ 85016-4219
Phone
(602) 778-3600
Fax
(801) 352-9502
NPI assigned
Sep 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 0101251839 VA
Internal Medicine Physician 207R00000X 37284 AZ
Internal Medicine Physician 207R00000X 0101251839 VA Primary

Addresses

Primary practice location

2525 E Camelback Rd
1100
Phoenix, AZ 85016-4219

Mailing address

PO Box 708850
Sandy, UT 84070-8850
Phone (866) 869-2395

Other identifiers 2

IdentifierTypeStateIssuer
P00418604OtherAZRAIL ROAD MEDICARE
300361MedicaidAZ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120817000281 VA Practitioner - HospitalistPractitioner - Internal Medicine 3678667649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vituity-Virginia Hospitalists PCGroup PAC ID 6507245131, 109 clinicians

Practice addresses (Care Compare)

5801 Bremo Rd
Richmond, VA 23226-1907
Phone (804) 285-2011

Hospital & facility affiliations

  • Bon Secours St Francis Medical Center Hospital, Midlothian, VA, CCN 490136

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
45777TNMDLicensed Practical Nurse
0101251839VAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vituity-Virginia Hospitalists PC Hospitalist CurrentSince Jun 1, 2022 Accepting new patients
Primedoc St.Francis PC Internal Medicine Past Accepting new patients
Apogee Medical Group Tennessee PC Internal Medicine PastSince Oct 8, 2023 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

13710 St Francis Blvd
Midlothian, VA 23114
Phone (804) 594-7300

5801 Bremo Rd
Richmond, VA 23226
Phone (804) 281-8220

1500 N 28th St
Richmond, VA 23223
Phone (804) 225-1700

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 11

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": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1962696856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 708850",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840708850",
            "telephone_number": "866-869-2395",
            "fax_number": "801-352-9502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 E CAMELBACK RD",
            "address_2": "1100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164219",
            "telephone_number": "602-778-3600",
            "fax_number": "801-352-9502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMURIA",
        "first_name": "ROBERT",
        "middle_name": "OMWOYO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-04",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0101251839",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "37284",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101251839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00418604",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300361",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.