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Deactivated NPI 1790784668 Deactivated / Inactive NPI Male Practitioner

Dr. Patrick Omalley , MD

Specialist • South Bend, IN

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Patrick Omalley has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 21, 2005
NPI Deactivation Date May 16, 2022
Total Practice Duration ~17 Years of Practice (2005 – 2022)

Professional Overview & Biography Verified Profile Summary

Dr. Patrick Omalley, MD was a registered Specialist practicing in South Bend, IN. Throughout an active medical career spanning 17 years, Dr. Omalley provided care at the practice location at 53822 GENERATIONS DR until profile deactivation on 2022-05-16.

Practice Location & Contact Primary Location

Practice Address

53822 Generations Dr

South Bend, IN 466351543

Telephone 5742333711
Fax 5742881702
Associated Practice Facility / Clinic
🏢 Retina & Vitreous L L C Facility NPI 1093999609

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in South Bend, IN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 35.0 Yrs
State Avg: 34.9 Yrs
Regional Practice Density
13 Specialists

Practicing in South Bend, IN (456 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License IN 01021791

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
NPI 1023017902

Doctor of Medicine (M.D.)

Dr. Robert Lee , MD

Ophthalmology

NPI 1962401869

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated May 16, 2022

Record deactivated on May 16, 2022

NPI Profile Active July 09, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 09, 2007

Registered at 53822 GENERATIONS DR, SOUTH BEND, IN 466351543 (Tel: 5742333711)

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Updated Business Mailing Address July 09, 2007

Registered at 53822 GENERATIONS DR, SOUTH BEND, IN 466351543 (Tel: 5742333711)

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Provider Name / Credentials Updated July 09, 2007

Recorded as PATRICK OMALLEY, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 09, 2007

Specialist (License #01021791 in IN)

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Initial NPI Registration & Enumeration July 21, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1790784668
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 21, 2005
Last Update: July 09, 2007
Deactivation Date: May 16, 2022

Mailing Address

53822 Generations Dr

South Bend, IN 466351543

Phone: 5742333711

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.