Individual provider Active NPI

Rebecca T. Obedian, MD

  • Diagnostic Radiology Physician
  • Lindenhurst, NY
National Provider Identifier
1053622423
Registry record updated Jun 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
245964 Issued in NY
Practice address
150 E Sunrise Hwy
Suite 208
Lindenhurst, NY 11757-2598
Phone
(631) 225-7200
Fax
(631) 930-9451
NPI assigned
Jun 30, 2010
Last updated
Jun 30, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 245964 NY Primary

Addresses

Primary practice location

150 E Sunrise Hwy
Suite 208
Lindenhurst, NY 11757-2598

Mailing address

150 E Sunrise Hwy
Suite 208
Lindenhurst, NY 11757-2598
Phone (631) 225-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101101000598 NY Practitioner - Diagnostic Radiology 7012101322 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Chicago, Pritzker School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

15636 A Crossbay Blvd
Howard Beach, NY 11414-2745
Phone (718) 738-0700

90 S Bedford Rd
Mount Kisco, NY 10549-3412
Phone (914) 241-1050

Merit-based Incentive Payment System (MIPS)

Final score
82.13 of 100Reported as group
Quality
72.13
Promoting interoperability
91
Improvement activities
40
Cost
75.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
245964NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Optum Urgent Care, PLLC CurrentSince Mar 21, 2018 Accepting new patients
St. Francis Cardiac Prevention Services PC Diagnostic Radiology CurrentSince Jul 1, 2021 Accepting new patients
Optum Medical Care, P.C. Diagnostic Radiology CurrentSince Sep 1, 2022 Accepting new patients
CHS Physician Partners, P.C Past Accepting new patients

Locations

101 Northern Blvd
Greenvale, NY 11548
Phone (516) 629-2090

2200 Northern Blvd
Ste 118
Greenvale, NY 11548
Phone (516) 563-7910

555 N Broadway
Jericho, NY 11753
Phone (516) 597-5070

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

2800 Marcus Ave
New Hyde Park, NY 11042
Phone (516) 622-6131

Philadelphia, PA 19195

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277856000000",
    "number": "1053622423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 E SUNRISE HWY",
            "address_2": "SUITE 208",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117572598",
            "telephone_number": "631-225-7200",
            "fax_number": "631-930-9451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E SUNRISE HWY",
            "address_2": "SUITE 208",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117572598",
            "telephone_number": "631-225-7200",
            "fax_number": "631-930-9451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBEDIAN",
        "first_name": "REBECCA",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-30",
        "last_updated": "2010-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "245964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lindenhurst, NY

Sources for this page

Verify at the official NPI Registry.