Active NPI
Bernadette A Obmaces, M.D
- Family Medicine Physician
- Valparaiso, IN
National Provider Identifier
1578790481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01072158A
- Practice address
- 3800 St Mary Dr
Suite 204
Valparaiso, IN 46383-7502 - Phone
- (219) 286-3765
- NPI assigned
- Jun 18, 2009
- Last updated
- Jul 25, 2013
- Sex
- Female
- 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 | 01072158A | IN | Primary |
Addresses
Primary practice location
3800 St Mary Dr
Suite 204
Valparaiso, IN 46383-7502
Mailing address
3800 St Mary Dr
Suite 204
Valparaiso, IN 46383-7502
Phone (219) 286-3765
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20113882 | Medicaid | IN |
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 |
|---|---|---|---|
| 01072158A | IN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Lima Memorial Health System
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374710400000",
"number": "1578790481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3800 ST MARY DR",
"address_2": "SUITE 204",
"city": "VALPARAISO",
"state": "IN",
"postal_code": "463837502",
"telephone_number": "219-286-3765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3800 ST MARY DR",
"address_2": "SUITE 204",
"city": "VALPARAISO",
"state": "IN",
"postal_code": "463837502",
"telephone_number": "219-286-3765"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBMACES",
"first_name": "BERNADETTE",
"middle_name": "A",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-18",
"last_updated": "2013-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01072158A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20113882",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Valparaiso, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.