Mark Joseph Oberthaler, PA-C
Individual provider Active NPI Physician Assistant · Wayne, NJ
NPI 1649688243 · NPPES record last updated Jul 28, 2014
Key facts
- NPI
- 1649688243
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- ER25MP00337700 (NJ)
- Practice address
- 504 Valley Rd
Wayne, NJ 07470-3534 - Phone
- (973) 694-2690
- NPI assigned
- Jul 27, 2014
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Physician Partners of Englewood PC
Practice addresses (Care Compare)
350 Engle St
Englewood, NJ 07631-1808
Hospital & facility affiliations
- Englewood Hospital and Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 96.09 of 100
- Quality
- 86.89
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150513000914 | NJ | Practitioner - Physician Assistant | 7810217932 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ER25MP00337700 | NJ | MD | Physician Assistant |
Interoperability endpoints
- moberthaler236182@direct.englewoodhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | ER25MP00337700 | NJ | Yes |
Addresses
Primary practice location
504 Valley Rd
Wayne, NJ 07470-3534
Mailing address
504 Valley Rd
Wayne, NJ 07470-3534
Phone (973) 694-2690
Other providers in Wayne, NJ
- Eileen O'Sullivan
- Timothy O'Sullivan
- Oakland Spine and Physical Therapy of Wayne, LLC
- OB-GYN Affiliates of North Jersey LLC
- Marci Wolff Ober
- Thomas M Obrotka
- Ogt Chiropractic Group, PA
- SE Young Oh
- Kelli Ohanlon
- Michael Idowu Ojelade
All providers in Wayne, NJ · Physician Assistant in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.