NPIMap

Individual provider Active NPI

Justyna Obara

  • Internal Medicine Physician
  • Vineland, NJ
National Provider Identifier
1174768048
Registry record updated Oct 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA08551400 Issued in NJ
Practice address
785 W Sherman Ave
Vineland, NJ 08360-6913
Phone
(856) 451-4700
NPI assigned
Dec 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA08551400 NJ Primary

Addresses

Primary practice location

785 W Sherman Ave
Vineland, NJ 08360-6913

Mailing address

785 W Sherman Ave
Vineland, NJ 08360-6913
Phone (856) 451-4700

Other names 1

  • Dr. Justyna Adamczyk Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20110127000316 NJ Practitioner - Internal Medicine 8022297720 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

159 S Broad St
Kha Woodbury
Woodbury, NJ 08096-2410
Phone (844) 542-2273

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08551400NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Care, Inc. CurrentSince Nov 1, 2011 Accepting new patients
Kennedy Medical Group Practice PC CurrentSince Aug 1, 2021 Accepting new patients
Kennedy Medical Group Practice, P.C. Internal Medicine CurrentSince Aug 1, 2021 Accepting new patients
Community Health Care, Inc. Internal Medicine CurrentSince Nov 1, 2011 Accepting new patients
Excelcare Alliance, LLC Internal Medicine CurrentSince May 2, 2017 Accepting new patients
Kennedy University Hospital Inc. Past Accepting new patients
Inspira Medical Centers, Inc. Past Accepting new patients
Dendrinos Medical Associates, P.a. Past Accepting new patients
Kennedy Medical Group Practice P.C. Past Accepting new patients

Locations

30 N Pearl St
Bridgeton, NJ 08302

457 Haddonfield Rd
Ste 110
Cherry Hill, NJ 08002
Phone (856) 406-4091

335 Delsea Dr N
Glassboro, NJ 08028
Phone (856) 863-5720

151 Fries Mill Rd
Ste 301
Turnersville, NJ 08012
Phone (856) 374-1881

2815 E Chestnut Ave
Vineland, NJ 08361
Phone (856) 691-3145

49 S State St
Vineland, NJ 08360
Phone (856) 696-3463

785 W Sherman Ave
Vineland, NJ 08360

2020 E Chestnut Ave
Vineland, NJ 08361
Phone (856) 563-1600

159 S Broad St
Woodbury, NJ 08096
Phone (844) 542-8273

Interoperability endpoints

  • Direct secure messaging: justyna.obara.2@12810.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/12810/brand/1/csg/1/fhir/r4

Organizations & group practices 9

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1228694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1174768048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 W SHERMAN AVE",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083606913",
            "telephone_number": "856-451-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 W SHERMAN AVE",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083606913",
            "telephone_number": "856-451-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBARA",
        "first_name": "JUSTYNA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-08",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA08551400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUSTYNA",
            "last_name": "ADAMCZYK",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vineland, NJ

Sources for this page

Verify at the official NPI Registry.