Individual provider Active NPI

Aaron Michael Omlor, P.A.

  • Physician Assistant
  • Rancho Mirage, CA
National Provider Identifier
1992948764
Registry record updated Feb 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
57555 Issued in CA
Practice address
36101 Bob Hope Dr Ste a
Rancho Mirage, CA 92270-2001
Phone
(760) 321-1315
Fax
(760) 321-1094
NPI assigned
Apr 9, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1086068 GA
Physician Assistant 363A00000X 57555 CA Primary

Addresses

Primary practice location

36101 Bob Hope Dr Ste a
Rancho Mirage, CA 92270-2001

Mailing address

1445 Passage St
Palm Springs, CA 92262-0587
Phone (047) 081-2749

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200403001748 CA Practitioner - Physician Assistant 3072942549 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
57555CAMDGeneral Practice Dentistry
1086068GAMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: aaron.omlor.p5@direct.mydohc.nextgenshare.com
  • Direct secure messaging: aaron.omlor.p2@direct.mydohc.nextgenshare.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1239235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1992948764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 PASSAGE ST",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922620587",
            "telephone_number": "047-081-2749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36101 BOB HOPE DR STE A",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922702001",
            "telephone_number": "760-321-1315",
            "fax_number": "760-321-1094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMLOR",
        "first_name": "AARON",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-09",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "1086068",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "57555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

Verify at the official NPI Registry.