Active NPI
Deja Rochelle Obiora, CSA
- Surgical Physician Assistant
- Lanham, MD
National Provider Identifier
1053708867
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 0136000393
- Practice address
- 5515 Lanteen St
Lanham, MD 20706-2580 - Phone
- (301) 575-4117
- NPI assigned
- Apr 20, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 0136000393 | VA | Primary |
Addresses
Primary practice location
5515 Lanteen St
Lanham, MD 20706-2580
Mailing address
5515 Lanteen St
Lanham, MD 20706-2580
Phone (301) 575-4117
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0136000393 | VA | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762128000000",
"number": "1053708867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5515 LANTEEN ST",
"city": "LANHAM",
"state": "MD",
"postal_code": "207062580",
"telephone_number": "301-575-4117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5515 LANTEEN ST",
"city": "LANHAM",
"state": "MD",
"postal_code": "207062580",
"telephone_number": "301-575-4117"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBIORA",
"first_name": "DEJA",
"middle_name": "ROCHELLE",
"credential": "CSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-20",
"last_updated": "2025-11-03",
"certification_date": "2025-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "VA",
"license": "0136000393",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lanham, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.