Brian R Obenza, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

TL1599 Issued in SC

Practice address

180 Wingo Way
Suite 204
Mt Pleasant, SC 29464-1810

Phone

(843) 534-1770

Fax

(843) 534-1767

NPI assigned

Dec 1, 2010

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Carolina Arrhythmia Consultants

  • Medical Physician Assistant
  • Mt Pleasant, SC
  • NPI 1861794042
  NPD (past)
• Carolina Arrhythmia Consultants, PA

  • Clinical Cardiac Electrophysiology Physician
  • Mt Pleasant, SC
  • NPI 1770585648
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1291161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291161600000",
    "number": "1053613786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 WINGO WAY",
            "address_2": "SUITE 204",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294641810",
            "telephone_number": "843-534-1770",
            "fax_number": "843-534-1767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 WINGO WAY",
            "address_2": "SUITE 204",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294641810",
            "telephone_number": "843-534-1770",
            "fax_number": "843-534-1767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBENZA",
        "first_name": "BRIAN",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-01",
        "last_updated": "2010-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "TL1599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oak Point Psychiatry, LLC
• Lyndsay Alexandra Oancea, M.D.
• Oasis Family Dentistry LLC
• Oasis Hyperbarics, LLC
• Connor Patrick Ryan Oates
• Stephanie Elaine Oberman, M.S.
• Kasey Christine Obermeier
• Suzanne Marie Oconnor, LPC
• Octavia & Main, LLC
• Anthony Robert Oddo, M.D.

• Medical Physician Assistant in Mt Pleasant, SC
• Providers in Mt Pleasant, SC by specialty
• Medical Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.