Individual provider Active NPI

Islam Obeidat, MD

  • Internal Medicine Physician
  • Flint, MI
National Provider Identifier
1326611427
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD2024-0172 Issued in NM
Practice address
G3230 Beecher Rd Ste 2
Flint, MI 48532-3604
Phone
(810) 342-5800
Fax
(810) 342-5810
NPI assigned
Jul 19, 2021
Last updated
Aug 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 4351047844 MI
Internal Medicine Physician 207R00000X MD2024-0172 NM Primary

Addresses

Primary practice location

G3230 Beecher Rd Ste 2
Flint, MI 48532-3604

Mailing address

1100 Central Ave SE
Albuquerque, NM 87106-4934
Phone (505) 724-6145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20240603001817 NM Practitioner - Internal Medicine 8628471703 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

1100 Central Ave SE
Albuquerque, NM 87106-4930
Phone (505) 841-1234

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.68 of 100Reported as group
Quality
82.35
Promoting interoperability
100
Improvement activities
40
Cost
76.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2024-0172NMMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services Internal Medicine CurrentSince Jul 15, 2024 Accepting new patients
Presbyterian Healthcare Services Internal Medicine CurrentSince Jul 15, 2024 Accepting new patients

Locations

1100 Central Ave SE
Albuquerque, NM 87106
Phone (505) 724-6124

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

Interoperability endpoints

  • Direct secure messaging: iobeidat251494@direct.phs.org

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 2

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": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1326611427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 CENTRAL AVE SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064934",
            "telephone_number": "505-724-6145",
            "fax_number": "505-724-6125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "G3230 BEECHER RD STE 2",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323604",
            "telephone_number": "810-342-5800",
            "fax_number": "810-342-5810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBEIDAT",
        "first_name": "ISLAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-19",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4351047844",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "MD2024-0172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.