Individual provider Active NPI

Baha Mohammed Taleb Obaidat, MBBS

  • Pulmonary Disease Physician
  • Kokomo, IN
National Provider Identifier
1437563772
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
01095229A Issued in IN
Practice address
3504 S Lafountain St
Kokomo, IN 46902-3803
Phone
(765) 776-3600
NPI assigned
Jun 15, 2014
Last updated
Jun 4, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD195613 OR
Critical Care Medicine (Internal Medicine) Physician 207RC0200X MD195613 OR
Pulmonary Disease Physician 207RP1001X MD195613 OR
Pulmonary Disease Physician 207RP1001X 01095229A IN Primary

Addresses

Primary practice location

3504 S Lafountain St
Kokomo, IN 46902-3803

Mailing address

2825 E Barnett Rd # MSS
Medford, OR 97504-8332
Phone (541) 789-4281

Other practice location 1

555 Black Oak Dr Ste 300
Medford, OR 97504-8491
Phone (541) 789-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20250326003212 IN Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 0749579613 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

3504 S Lafountain St
Kokomo, IN 46902-3803
Phone (765) 453-8600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD195613ORMDInternal Medicine Physician
01095229AINMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physician Network Specialty Care LLC CurrentSince Feb 2, 2026 Accepting new patients
Community Physicians of Indiana Inc Internal Medicine CurrentSince Apr 28, 2025 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Apr 28, 2025 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

8040 Clearvista Pkwy
Ste 290
Indianapolis, IN 46256
Phone (317) 621-0401

3504 S Lafountain St
Kokomo, IN 46902
Phone (765) 453-8439

Interoperability endpoints

  • Direct secure messaging: bobaidat638917@ecommunitydirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1402790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1437563772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 E BARNETT RD # MSS",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048332",
            "telephone_number": "541-789-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3504 S LAFOUNTAIN ST",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023803",
            "telephone_number": "765-776-3600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 Black Oak Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975048491",
            "country_code": "US",
            "telephone_number": "541-789-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OBAIDAT",
        "first_name": "BAHA",
        "middle_name": "MOHAMMED TALEB",
        "name_prefix": "Dr.",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-15",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD195613",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OR",
            "license": "MD195613",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OR",
            "license": "MD195613",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IN",
            "license": "01095229A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

Verify at the official NPI Registry.