NPIMap

Individual provider Active NPI

Mark E Oberlies, MD

  • Internal Medicine Physician
  • Omaha, NE
National Provider Identifier
1194883298
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
21729 Issued in NE
Practice address
16909 Lakeside Hills CT Ste 111
Omaha, NE 68130
Phone
(402) 810-9700
Fax
(402) 858-1281
NPI assigned
Dec 4, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 21729 NE Primary

Addresses

Primary practice location

16909 Lakeside Hills CT Ste 111
Omaha, NE 68130

Mailing address

16909 Lakeside Hills CT Ste 111
Omaha, NE 68130-4661
Phone (402) 810-9700

Other practice location 1

17030 Lakeside Hills Plz
Suite 102
Omaha, NE 68130
Phone (402) 758-5800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20070320000484 NE Practitioner - Internal Medicine 8426151010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
State University of New York at Buffalo School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

16909 Lakeside Hills CT
Suite 111
Omaha, NE 68130-4661
Phone (402) 810-9700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21729NEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mark E Oberlies MD PC Internal Medicine CurrentSince Oct 1, 2018 Accepting new patients
Alegent Creighton Clinic Past Accepting new patients

Locations

16909 Lakeside Hills Ct
Ste 111
Omaha, NE 68130
Phone (402) 810-9700

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1194883298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16909 LAKESIDE HILLS CT STE 111",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681304661",
            "telephone_number": "402-810-9700",
            "fax_number": "402-858-1281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16909 LAKESIDE HILLS CT STE 111",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68130",
            "telephone_number": "402-810-9700",
            "fax_number": "402-858-1281"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17030 Lakeside Hills Plz",
            "address_2": "SUITE 102",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "68130",
            "country_code": "US",
            "telephone_number": "402-758-5800",
            "fax_number": "402-758-5809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OBERLIES",
        "first_name": "MARK",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "21729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.