Individual provider Active NPI

Eugene A Obah, M.D.

  • Internal Medicine Physician
  • Baltimore, MD
National Provider Identifier
1760429922
Registry record updated Dec 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D44018 Issued in MD
Practice address
6565 N Charles St
Ste 203
Baltimore, MD 21204-6800
Phone
(443) 849-3760
NPI assigned
May 31, 2006
Last updated
Dec 21, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D44018 MD Primary

Addresses

Primary practice location

6565 N Charles St
Ste 203
Baltimore, MD 21204-6800

Mailing address

PO Box 418953
Boston, MA 02241-8953

Other identifiers 3

IdentifierTypeStateIssuer
S1380014OtherMDCAREFIRST REGIONAL GBMC
644001100MedicaidMD
KJ15GB/529852-01OtherMDCAREFIRST MARYLAND GBMC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100202000498 MD Practitioner - Internal Medicine 2668515461 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agape Physical Therapy and Sports Rehabilitation LPGroup PAC ID 3870741390, 684 clinicians
Greater Baltimore Medical CenterGroup PAC ID 1759276975, 350 clinicians

Practice addresses (Care Compare)

12 Newport Dr
Suite a
Forest Hill, MD 21050-1758

6565 N Charles St
203 Medicine GBMC
Baltimore, MD 21204-5805
Phone (410) 828-3760

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D44018MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Baltimore Medical Center, Inc. Internal Medicine CurrentSince Jul 1, 1999 Accepting new patients
Greater Baltimore Medical Center, Inc. CurrentSince Jul 1, 1999 Accepting new patients
Greater Baltimore Medical Center, Inc Current Accepting new patients
Greater Baltimore Medical Center, Inc. Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

6565 N Charles St
Ste 203
Towson, MD 21204
Phone (410) 828-3760

6569 N Charles St
Ste 307
Towson, MD 21204
Phone (443) 849-2767

6569 N Charles St
Ste 505
Towson, MD 21204
Phone (443) 849-2196

Interoperability endpoints

  • Direct secure messaging: eobah8085@gbmcdirect.org

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324425600000",
    "number": "1760429922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 418953",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022418953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6565 N CHARLES ST",
            "address_2": "STE 203",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212046800",
            "telephone_number": "443-849-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBAH",
        "first_name": "EUGENE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2011-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D44018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST REGIONAL GBMC",
            "identifier": "S1380014",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "644001100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MARYLAND GBMC",
            "identifier": "KJ15GB/529852-01",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.