Active NPI
Thomas Obisesan, MD
- Geriatric Medicine (Internal Medicine) Physician
- Washington, DC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- License
- MD19950
- Practice address
- 2041 Georgia Ave NW
Washington, DC 20060-0001 - Phone
- (202) 865-3290
- Fax
- (202) 865-3833
- NPI assigned
- Dec 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | MD19950 | DC | Primary |
Addresses
Primary practice location
2041 Georgia Ave NW
Washington, DC 20060-0001
Mailing address
2041 Georgia Ave NW Tower 6101
Washington, DC 20060-0001
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 758141601 | Medicaid | MD | |
| 010015413 | Medicaid | VA | |
| 023971400 | Medicaid | DC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Geriatric Medicine
- Education
- Other, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2041 Georgia NW Ave
Washington, DC 20060-0001
Phone (202) 865-6679
Hospital & facility affiliations
- Howard University Hospital Corp
- Washington Ctr for Aging SVCS
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD19950 | DC | MD | Geriatric Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Howard University | Current | Accepting new patients | |
| Stoddard Baptist Global Care | Past | Accepting new patients |
Locations
2139 Georgia Ave NW
Washington, DC 20001
Phone (202) 865-1121
4414 Benning Rd NE
Fl 2
Washington, DC 20019
Phone (202) 865-2120
2041 Georgia Ave NW
#6101
Washington, DC 20060
2041 Georgia Ave NW
Washington, DC 20060
Phone (202) 865-3785
2101 Medical Park Dr
Ste 305
Silver Spring, MD 20902
Phone (301) 754-0833
Interoperability endpoints
- thomasobisesan@hufp.allscriptsdirect.net
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 and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Washington, DC
- NPI 1033163597
-
- Skilled Nursing Facility
- Washington, DC
- NPI 1851618714
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Washington, DC
- NPI 1487740957
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574380800000",
"number": "1295894426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2041 GEORGIA AVE NW TOWER 6101",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200600001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2041 GEORGIA AVE NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200600001",
"telephone_number": "202-865-3290",
"fax_number": "202-865-3833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBISESAN",
"first_name": "THOMAS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-06",
"last_updated": "2019-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "DC",
"license": "MD19950",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "758141601",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010015413",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "023971400",
"state": "DC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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.