Active NPI
Sam Obgartel
- Family Medicine Physician
- Luling, LA
National Provider Identifier
1457769234
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- AP07934
- Practice address
- 843 Milling Ave
Luling, LA 70070-4442 - Phone
- (504) 575-3712
- Fax
- (504) 575-3691
- NPI assigned
- Jul 24, 2014
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | AP07934 | LA | Primary |
Addresses
Primary practice location
843 Milling Ave
Luling, LA 70070-4442
Mailing address
2900 Indiana Ave
Kenner, LA 70065-4605
Phone (504) 575-3712
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170301001078 | LA | Order and Referring Only - Nurse Practitioner | 0042518953 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP07934 | LA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Access Health Louisiana | Family Medicine | Past | Accepting new patients |
Interoperability endpoints
- sam.obgartel.1@11331.direct.athenahealth.com
Organizations & group practices 1
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.
-
- Federally Qualified Health Center (FQHC)
- Kenner, LA
- NPI 1417999327
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487548800000",
"number": "1457769234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2900 INDIANA AVE",
"city": "KENNER",
"state": "LA",
"postal_code": "700654605",
"telephone_number": "504-575-3712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "843 MILLING AVE",
"city": "LULING",
"state": "LA",
"postal_code": "700704442",
"telephone_number": "504-575-3712",
"fax_number": "504-575-3691"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBGARTEL",
"first_name": "SAM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-07-24",
"last_updated": "2017-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "LA",
"license": "AP07934",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Luling, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.