Individual provider Active NPI

Edward Obazee, M.D.

  • Specialist
  • Baltimore, MD
National Provider Identifier
1194772905
Registry record updated Nov 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
D41430 Issued in MD
Practice address
821 N Eutaw St
Baltimore, MD 21201-4648
Phone
(410) 206-3839
Fax
(410) 664-4031
NPI assigned
May 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X D41430 MD Primary

Addresses

Primary practice location

821 N Eutaw St
Baltimore, MD 21201-4648

Mailing address

PO Box 356
Baltimore, MD 21203-0356
Phone (410) 206-3839

Other identifiers 1

IdentifierTypeStateIssuer
13861800MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20110404000395 MD Practitioner - Internal MedicinePractitioner - Pulmonary Disease 7719161587 Practice locations: Brooklyn Park, MD; Randallstown, MD

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pulmonary Disease
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5721 Ritchie Hwy
Brooklyn Park, MD 21225-3640
Phone (410) 401-0101

8507 Liberty Rd
Randallstown, MD 21133-4833
Phone (443) 636-6061

Hospital & facility affiliations

  • Future Care Homewood Nursing home, Baltimore, MD, CCN 215249

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Health First Urgent Care LLC CurrentSince Sep 5, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Charles Street Healthcare, LLC Past Accepting new patients

Locations

5721 Ritchie Hwy
Brooklyn Park, MD 21225
Phone (410) 206-3839

Organizations & group practices 3

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288828800000",
    "number": "1194772905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 356",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212030356",
            "telephone_number": "410-206-3839",
            "fax_number": "410-664-4031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 N EUTAW ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212014648",
            "telephone_number": "410-206-3839",
            "fax_number": "410-664-4031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBAZEE",
        "first_name": "EDWARD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2010-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "D41430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13861800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.