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

Insoo Om, PA

Individual provider Physician Assistant · NPI 1538364989

Insoo Om, PA is a Physician Assistant in Bronx, New York. Qualified in 1990, 36 years ago. Practices with Vanguard Dermatology, a 10-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
36
Licensed in
NY
In the registry since
2007
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

220 E 161st St
Bronx, NY 10451-3543
Phone: (718) 537-1100
Fax: (718) 537-0588
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 004057 (NY)

Record details

NPI number1538364989
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorYes
NPI enumeratedJune 17, 2007
Last updated in NPPESJuly 8, 2007

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1990 (36 years in practice)
Group practice Vanguard Dermatology — 10 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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