Nicholas Obertis Jr., PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

019242 Issued in NY

Practice address

200 Chambers St
New York, NY 10007-1131

Phone

(212) 962-6600

Fax

(212) 962-6605

NPI assigned

Oct 22, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, CT, MI, NJ, WI5 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 5

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Aldad Medical PCGroup PAC ID 9234291436, 78 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Aldad Medical PC

  • Psychiatry Physician
  • Ann Arbor, MI
  • NPI 1174784953

  CT, NY, WI

  Medicare reassignment Care Compare group
• Aldad Medical NJ, P.C

  • Psychiatry Physician
  • Hoboken, NJ
  • NPI 1386238707
  Medicare reassignment

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

{
    "created_epoch": "1445472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445472000000",
    "number": "1518339019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CHAMBERS ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100071131",
            "telephone_number": "212-962-6600",
            "fax_number": "212-962-6605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CHAMBERS ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100071131",
            "telephone_number": "212-962-6600",
            "fax_number": "212-962-6605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBERTIS",
        "first_name": "NICHOLAS",
        "name_suffix": "Jr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-22",
        "last_updated": "2015-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "019242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Oberndorf, NP
• Adrienne M Oberndorfer
• Lindi Oberon, PT
• Paul Eliezer Oberstein, MD
• Rebecca Obert, SLP-CCC
• Claudia Oberweger
• OBGYN Associates of St Lukes Roosevelt Hospital
• Adaeze Flora Obi
• Vivian C Obi
• Joseph Uchechukwu Obiajulu, MD

• Physician Assistant in New York, NY
• Providers in New York, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.