# OMEGA PHYSICIANS LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629653563
- **Authorized official:** NAGASASIKANTH R MOPURI MD (OWNER)
- **Authorized official phone:** (404) 702-0995

## Contact information

- **Practice address:** 103 OLD MARLTON PIKE STE 124, MEDFORD, NJ 08055-8772
- **Practice address phone:** (888) 575-9162
- **Mailing address:** 103 OLD MARLTON PIKE STE 124, MEDFORD, NJ 08055-8772
- **Mailing address phone:** (888) 575-9162
- **Mailing address fax:** (980) 987-4391

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 103TA0400X | Addiction (Substance Use Disorder) Psychologist | — | NULL | — |
| 103TA0400X | Addiction (Substance Use Disorder) Psychologist | — | — | — |
| 163WP0808X | Psychiatric/Mental Health Registered Nurse | — | NULL | — |
| 163WP0808X | Psychiatric/Mental Health Registered Nurse | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | — | — |
| 207VX0000X | Obstetrics Physician | — | NULL | — |
| 207VX0000X | Obstetrics Physician | — | — | — |
| 2084P0802X | Addiction Psychiatry Physician | — | NULL | — |
| 2084P0802X | Addiction Psychiatry Physician | — | — | — |
| 208VP0000X | Pain Medicine Physician | — | NULL | — |
| 208VP0000X | Pain Medicine Physician | — | — | — |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 03/12/2021
- **Last updated:** 08/26/2025