NPIMap

Individual provider Active NPI

Hebroon Obaid

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Duluth, MN
National Provider Identifier
1447660204
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
70179 Issued in MN
Practice address
920 E 1St St Ste 302
Duluth, MN 55805-2225
Phone
(218) 249-5555
NPI assigned
May 2, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2021

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 CT
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 70179 MN Primary

Addresses

Primary practice location

920 E 1St St Ste 302
Duluth, MN 55805-2225

Mailing address

920 E 1St St Ste 302
Duluth, MN 55805-2225

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@slk.direct.slhduluth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20211004000040 MN Practitioner - Thoracic Surgery 6002214269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Luke'S Hospital of DuluthGroup PAC ID 7113834839, 409 clinicians

Practice addresses (Care Compare)

920 E 1St St
Suite 302
Duluth, MN 55805-2225
Phone (218) 249-6050

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Duluth, MN, CCN 240047
  • Community Memorial Hospital Hospital, Cloquet, MN, CCN 241364
  • Cook Hospital Hospital, Cook, MN, CCN 241312

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)16

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Hospital of Duluth Current Accepting new patients
St. Luke'S Hospital of Duluth CurrentSince Sep 20, 2021 Accepting new patients
St. Luke'S Hospital of Duluth CurrentSince Sep 20, 2021 Accepting new patients
St. Luke'S Hospital of Duluth Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

920 E 1st St
Ste 302
Duluth, MN 55805
Phone (218) 249-6050

920 E 1st St
Ste 303
Duluth, MN 55805
Phone (218) 249-6050

915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352

1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860

Interoperability endpoints

  • Direct secure messaging: hobaid237531@direct.aspirus.org

Organizations & group practices 4

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.

Hospital & facility affiliations 28

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 28

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1398988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1447660204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 E 1ST ST STE 302",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 E 1ST ST STE 302",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052225",
            "telephone_number": "218-249-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBAID",
        "first_name": "HEBROON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-02",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MN",
            "license": "70179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@slk.direct.slhduluth.com",
            "affiliation": "N",
            "address_1": "920 E 1st St Ste 302",
            "city": "Duluth",
            "state": "MN",
            "country_code": "US",
            "postal_code": "558052225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.