NPIMap

Individual provider Active NPI

Mark Francis Obenrader, MD PHD

  • Family Medicine Physician
  • Fort Washington, PA
National Provider Identifier
1083698229
Registry record updated Oct 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD025847E Issued in PA
Practice address
515 Pennsylvania Ave
2ND FL Suite a
Fort Washington, PA 19034-3314
Phone
(215) 540-8408
Fax
(215) 540-8418
NPI assigned
Dec 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD025847E PA Primary

Addresses

Primary practice location

515 Pennsylvania Ave
2ND FL Suite a
Fort Washington, PA 19034-3314

Mailing address

PO Box 820933
Philadelphia, PA 19182-0933
Phone (215) 540-8408

Other identifiers 10

IdentifierTypeStateIssuer
007057785MedicaidPA
110115445OtherPARAILROAD MEDICARE
P00360693OtherPARAILROAD MEDICARE TPI
12212OtherPABRAVO HEALTH
445439OtherPAHIGHMARK BLUE SHIELD
3725226OtherPAAETNA HMO
3Y7167OtherPAHEALTH NET
4104719OtherPAAETNA PPO
30019076OtherPAKEYSTONE MERCY HEALTH PL
0047316000OtherPAINDEPENDENCE BLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050201000820 PA Practitioner - Family Practice 0648221291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Temple University School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians
Temple Physicians IncGroup PAC ID 2062317233, 154 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

515 Pennsylvania Ave a
Fort Washington, PA 19034-3317
Phone (215) 540-5408

Hospital & facility affiliations

  • Holy Redeemer Home Care-PA Home health agency, Philadelphia, PA, CCN 397104
  • Jefferson Health at Home by Bayada Home health agency, Horsham, PA, CCN 397145
  • Accentcare Health of Pennsylvania Home health agency, Bristol, PA, CCN 397472
  • Premier Home Care Inc Home health agency, Huntingdon Valley, PA, CCN 398040
  • Mercy Home Health Home health agency, Newtown, PA, CCN 397015
  • Temple Health - Chestnut Hill Hospital Hospital, Philadelphia, PA, CCN 390026
  • Doylestown Hospital Hospital, Doylestown, PA, CCN 390203
  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
  • Paoli Hospital Hospital, Paoli, PA, CCN 390153
  • Temple University Hospital Hospital, Philadelphia, PA, CCN 390027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD025847EPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Physician Inc. CurrentSince Jan 1, 2005 Accepting new patients
Temple Physicians Inc Family Medicine Current Accepting new patients
Temple Physicians Inc CurrentSince Jan 1, 2005 Accepting new patients
Temple Physicians Inc Family Medicine Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Ambler Medical Associates, Inc. Family Medicine Past Accepting new patients

Locations

515 Pennsylvania Ave
Ste A
Fort Washington, PA 19034
Phone (215) 540-5408

515 Pennsylvania Ave
Ft Washington, PA 19034
Phone (215) 641-0700

515 Pennsylvania Ave
Fl 2
Ft Washington, PA 19034
Phone (215) 540-0120

8200 Flourtown Ave
Ste 6
Wyndmoor, PA 19038
Phone (215) 233-1555

Organizations & group practices 6

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.

Hospital & facility affiliations 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380585600000",
    "number": "1083698229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 820933",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191820933",
            "telephone_number": "215-540-8408",
            "fax_number": "215-540-8418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 PENNSYLVANIA AVE",
            "address_2": "2ND FL SUITE A",
            "city": "FORT WASHINGTON",
            "state": "PA",
            "postal_code": "190343314",
            "telephone_number": "215-540-8408",
            "fax_number": "215-540-8418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBENRADER",
        "first_name": "MARK",
        "middle_name": "FRANCIS",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2013-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD025847E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007057785",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110115445",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE TPI",
            "identifier": "P00360693",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRAVO HEALTH",
            "identifier": "12212",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "445439",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3725226",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "3Y7167",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "4104719",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY HEALTH PL",
            "identifier": "30019076",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "0047316000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Washington, PA

Sources for this page

Verify at the official NPI Registry.