Jonathan Jeremy Obrien, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9959 Issued in AZ

Practice address

635 E Baseline Rd
Phoenix, AZ 85042-6583

Phone

(602) 243-7277

NPI assigned

Dec 9, 2022

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 AZ

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 1

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Good Health Medical PLLCGroup PAC ID 3779680962, 215 clinicians

Mountain Park Health CenterGroup PAC ID 8325949647, shared by 11 NPIs, 117 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Good Health Medical, PLLC

  • Family Medicine Physician
  • Mesa, AZ
  • NPI 1144764432
  Medicare reassignment Care Compare group
• Good Health Medical, PLLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1023828431
  NPD
• Good Health Medical, PLLC

  • Family Medicine Physician
  • Tempe, AZ
  • NPI 1881425130
  NPD
• Mountain Park Health Center

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1386452415
  NPD
• Mountain Park Health Center

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1558308825
  NPD
• Mountain Park Health Center - Dental

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1710146188
  NPD (past)

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

{
    "created_epoch": "1670544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1639880644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 E BASELINE RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850426583",
            "telephone_number": "602-243-7277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 E BASELINE RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850426583",
            "telephone_number": "602-243-7277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBRIEN",
        "first_name": "JONATHAN",
        "middle_name": "JEREMY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-09",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "9959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Agnes Elizabeth Oblas, ANP-C
• Barry Oblas, MSW
• Lindsey Ann Oboyle, MA, BCBA
• Aleksandra Obradov, M.D.
• Andrew Obrien
• Obstetrics & Gynecology Consultants PC
• Obstetrics and Pediatrics Subspecialty Group of Kansas and Missouri PA
• Obstetrix Medical Group of Phoenix PC
• William Obur
• Amber Rose Ocampo, OTD, OTR/L

• Physician Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; 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.