Carlos Oblena Dator Jr., MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

281672 Issued in NY

Practice address

110 W 6TH St
Oswego, NY 13126-2507

Phone

(315) 349-5511

NPI assigned

May 24, 2012

Sex

Male

Sole proprietor

Yes

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

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

Specialty

Family Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Oswego HospitalGroup PAC ID 4981686045, 59 clinicians

Carmen Bautista-Dator MD PCGroup PAC ID 4688617764, 2 clinicians

Dator Medical, PLLCGroup PAC ID 5799276549, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Liverpool, NY, CCN 337255
• Oswego Hospital Hospital, Oswego, NY, CCN 330218

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Dator Medical PLLC

  • Family Medicine Physician
  • Oswego, NY
  • NPI 1841172368
  Medicare reassignment Care Compare group NPD Authorized official
• Carmen Bautista-Dator MD PC

  • Internal Medicine Physician
  • Oswego, NY
  • NPI 1912066242
  Medicare reassignment Care Compare group NPD
• Oswego Hospital

  • General Acute Care Hospital
  • Oswego, NY
  • NPI 1871678458
  Medicare reassignment Care Compare group
• Pons Physician Services, PLLC

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Cortland, NY
  • NPI 1457732554

  Family Medicine

  Medicare reassignment NPD
• University Surgical Associates, LLP

  • Surgery Physician
  • Syracuse, NY
  • NPI 1376590117
  NPD (past)

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

• Oswego Hospital

  • General Acute Care Hospital
  • Oswego, NY
  • NPI 1871678458
  Care Compare affiliation
• QC-Medi New York, Inc.

  • Home Health Agency
  • Syracuse, NY
  • NPI 1912939489
  Care Compare affiliation

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

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551916800000",
    "number": "1114287158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W 6TH ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131262507",
            "telephone_number": "315-349-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W 6TH ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131262507",
            "telephone_number": "315-349-5511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "177 W 4th St",
            "address_purpose": "LOCATION",
            "city": "Oswego",
            "state": "NY",
            "postal_code": "131263009",
            "country_code": "US",
            "telephone_number": "315-343-2151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DATOR",
        "first_name": "CARLOS",
        "middle_name": "OBLENA",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-24",
        "last_updated": "2019-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "281672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Marie Darling
• Venkata Ramani Dasari, M.D.
• Daskalakis Psychological Services, PC
• Katherine Daskalakis, PHD
• Dator Medical PLLC
• Carlos Oblena Dator, MD
• Melissa Virginia Dauccio
• David a Vecchio, LMSW Counseling Services PC
• David J. Dexter, O.D., P.C.
• Maureen Susan David, OTRL

• Family Medicine Physician in Oswego, NY
• Providers in Oswego, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.