Active NPI
Gary D Oberg, M.D.
- Psychiatry Physician
- Saratoga Springs, NY
National Provider Identifier
1407820954
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 150573-1
- Practice address
- 211 Church St
Saratoga Springs, NY 12866-1046 - Phone
- (518) 584-9030
- Fax
- (518) 581-1709
- NPI assigned
- Feb 13, 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 150573-1 | NY | Primary |
Addresses
Primary practice location
211 Church St
Saratoga Springs, NY 12866-1046
Mailing address
211 Church St
Saratoga Springs, NY 12866-1046
Phone (518) 584-9030
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00639496 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 150573-1 | NY | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217980800000",
"number": "1407820954",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 CHURCH ST",
"city": "SARATOGA SPRINGS",
"state": "NY",
"postal_code": "128661046",
"telephone_number": "518-584-9030",
"fax_number": "518-581-1709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 CHURCH ST",
"city": "SARATOGA SPRINGS",
"state": "NY",
"postal_code": "128661046",
"telephone_number": "518-584-9030",
"fax_number": "518-581-1709"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBERG",
"first_name": "GARY",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-13",
"last_updated": "2008-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "150573-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00639496",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saratoga Springs, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.