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OMER TIPU PHYSICIAN PC
NPI 1780004358
Family Medicine - Geriatric Medicine in Brooklyn, NY

Active since April 23, 2014
446 MCDONALD AVE, BROOKLYN, NY 11218(718) 972-4200 Get Directions Write a Review

NPPES record last updated: August 1, 2014. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Omer Tipu Physician Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OMER TIPU PHYSICIAN PC (NPI 1780004358) is a healthcare organization registered as a geriatric medicine in Brooklyn, New York and active in the NPI registry since April 2014. The organization lists Omer Tipu, President, as its authorized official.

NPPES Registry Identity

NPI1780004358
Entity TypeOrganization
Primary Taxonomy207QG0300X
Legal Business NameOMER TIPU PHYSICIAN PC
Location Address446 MCDONALD AVEBrooklyn, NY 11218-2212
Mailing Address710 Sunnyview OvalKeasbey, NJ 08832-1039 · (718) 972-4200
Phone(718) 972-4200
Organization SubpartNo
Authorized OfficialOmer TipuPresident · (718) 972-4200
Enumeration DateApril 23, 2014
Last NPPES UpdateAugust 1, 2014
✔ NPI 1780004358 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QG0300X
Definition
A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.
446 MCDONALD AVE, Brooklyn, NY 11218
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Other Identifiers 2

Medicare PINA100105645NY
Medicaid03850084NY

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Omer Tipu Physician Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateNew YorkEnrollment IDO20140725001583Non-DME Part B · Clinic/Group PracticeDue dateDecember 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Omer Tipu Physician PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Omer Tipu, MD
Family Practice
NPI 1669601159
446 MCDONALD AVE
Brooklyn, NY 11218
(718) 972-4200
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Omer Tipu Physician PC's NPI number?

The NPI number for Omer Tipu Physician PC is 1780004358. It was assigned to this organization in the NPPES registry on April 23, 2014.

Where is Omer Tipu Physician PC located?

Omer Tipu Physician PC is located at 446 Mcdonald Ave, Brooklyn, NY 11218. The listed phone number is (718) 972-4200.

What is Omer Tipu Physician PC's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Geriatric Medicine, with taxonomy code 207QG0300X.

Is Omer Tipu Physician PC enrolled in Medicare?

Yes. Omer Tipu Physician PC is registered in the Medicare PECOS enrollment system.

When is Omer Tipu Physician PC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New York, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Omer Tipu Physician PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Omer Tipu Physician PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Omer Tipu Physician PC was last updated on August 1, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.