OMAR DYARA (NPI# 1285077404) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285077404 |
| Entity Type | Individual |
| Full Name | OMAR DYARA |
| Practice Address |
959 N Mayfair Rd Wauwatosa WI 53226-3465 |
| Mailing Address |
9200 W Wisconsin Ave Milwaukee WI 53226-3522 |
| Practice Telephone | 4149553955 |
| Mailing Telephone | 4148058700 |
| Mailing Fax Number | 4142591522 |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2018-08-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | 69530 | WI | Allopathic & Osteopathic Physicians |
| N | 207L00000X | Anesthesiology | 20A15228 | CA | Allopathic & Osteopathic Physicians |
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
69530 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1285077404 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 9200 W Wisconsin Ave, Milwaukee, WI 532263522 | 4148058700 | 4142591522 |
| Street Address |
959 N MAYFAIR RD |
| City | WAUWATOSA |
| State | WI |
| Zip Code | 53226-3465 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437796091 | Lisa Elliott | Nurse Practitioner | 959 N Mayfair Rd, Wauwatosa, WI 53226-3465 | 2019-12-03 |
| 1871955674 | Darshan B Patel | Anesthesiology | 959 N Mayfair Rd, Wauwatosa, WI 53226-3465 | 2016-03-22 |
| 1649663758 | Pain Centers of Wisconsin - Wauwatosa, LLC | Durable Medical Equipment & Medical Supplies | 959 N Mayfair Rd, Wauwatosa, WI 53226-3465 | 2015-03-13 |
| 1245653880 | Emily Mcclory | Registered Nurse | 959 N Mayfair Rd, Wauwatosa, WI 53226-3465 | 2014-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912511155 | Alexander Harlan | Pharmacist | 900 N 92nd St, Milwaukee, WI 53226 | 2020-09-04 |
| 1558985762 | Armghan Haider Ans | Student in an Organized Health Care Education/Training Program | 9200 W. Wisconsin Ave. Froedtert Hospital & Medical Col, Milwaukee, WI 53226 | 2020-06-03 |
| 1669001103 | Kimberly Tyler | Student in an Organized Health Care Education/Training Program | 8701 W Watertown Plank Road, Medical College of Wisconsin Dept of Internal Medicine, Wauwatosa, WI 53226 | 2020-04-06 |
| 1972131993 | Francesca Meloy Devine | Student in an Organized Health Care Education/Training Program | Medical Education Office: Children's Corporate Center, 999 N. 92nd St., Suite 730, Milwaukee, WI 53226 | 2020-03-27 |
| 1285275248 | Sharitta Alford | Technician | 12250 West North Avenue, Apartment 142b, Wauwatosa, WI 53226 | 2019-10-01 |
| 1619528023 | Linda Marie Sabatinelli | Technician | 12107 W. Woodland Ave, Wauwatosa, WI 53226 | 2019-09-26 |
| 1598310195 | Matthew Laviolette | Surgery | Medical College of Wisconsin, 8701 Watertown Plank Rd., Surgical Oncology, Milwaukee, WI 53226 | 2019-08-09 |
| 1962056432 | Lyndsey Marie Bratberg | Physician Assistant | F&mcw Clinical Cancer Center 9200 W. Wisconsin Ave., Milwaukee, WI 53226 | 2019-08-01 |
| 1659832855 | Benjamin David Seadler | Surgery | Mcw, Department of Surgery, 8701 Watertown Plank Road, Milwaukee, WI 53226 | 2019-03-29 |
| 1861953267 | Michael Dryden | Student in an Organized Health Care Education/Training Program | 8701 Watertown Plank Rd., Milwaukee, WI 53226 | 2019-03-27 |
| Find all providers in zip 53226 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700309101 | Wisconsin Interventional Pain Solutions Sc | Anesthesiology | 2500 N Mayfair Rd Ste 325, Wauwatosa, WI 53226-1443 | 2017-07-18 |
| 1700954153 | Athlene A. Alexis, M.d., S.c. | Anesthesiology | 10900 W Potter Rd, Wauwatosa, WI 53226-3424 | 2006-12-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528402781 | Aspen Wellness and Pain Medicine Center | Anesthesiology | W176n9830 Rivercrest Dr Ste 102, Germantown, WI 53022-4692 | 2013-04-18 |
| 1720307283 | Andres Fernando Quitzon Jr. | Anesthesiology | 2245 W Brantwood Ave, Milwaukee, WI 53209 | 2010-05-24 |
| 1861688418 | Horizon Interventional Pain Physicians, Sc | Anesthesiology | 7071 S 13th St, Suite # 102, Oak Creek, WI 53154-1466 | 2007-09-18 |
| 1992800791 | Interventional Pain Specialists of Wisconsin, Sc | Anesthesiology | 2021 Cenex Dr, Suite J, Rice Lake, WI 54868-1891 | 2006-09-14 |
| 1275500910 | Saleem Awan | Anesthesiology | 4570 S 27th St, Milwaukee, WI 53221-2145 | 2006-03-01 |
| 1871560581 | Yogendra Bharat | Anesthesiology | 2500 W Layton Ave Ste 170, Milwaukee, WI 53221-5433 | 2006-03-01 |
| 1871569830 | Roman Berezovski | Anesthesiology | 4131 W. Loomis Rd., Ste 300, Greenfield, WI 53221-2059 | 2006-02-28 |
| 1598762841 | Nathan C Meloy | Anesthesiology | 2700 W 9th Ave, Suite 205, Oshkosh, WI 54904-7247 | 2005-07-01 |
| 1922457803 | Holly Haberman | Anesthesiology | 710 Riverside Dr, Waupaca, WI 54981-1941 | 2016-06-10 |
| 1639531650 | Braden Woodhouse Jex | Anesthesiology | 9200 W Wisconsin Ave, P348, Milwaukee, WI 53226-3522 | 2016-03-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.