Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Derek Omori, PA

Individual provider Physician Assistant · NPI 1699143263

Derek Omori, PA is a Physician Assistant in Riverton, Utah. Qualified in 2015, 11 years ago. Practices with Ihc Health Services Inc, a 3,947-clinician group and accepts Medicare assignment.

Years since qualifying
11
In the registry since
2015
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

3723 W 12600 S Ste 450
Riverton, UT 84065-7296
Phone: (801) 285-4673
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1699143263
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 12, 2015
Last updated in NPPESDecember 24, 2023
Certification dateDecember 24, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Ihc Health Services Inc — 3947 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations11 on file with Medicare

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