Mary Obear MD PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MARY OBEAR MD PLLC

Practice address

860 Main Road
Corfu, NY 14036-9753

Phone

(585) 599-6446

Fax

(585) 599-3166

NPI assigned

Jul 28, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Mary E Obear, MD

Title

Owner

Phone

(585) 599-6446

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Pembroke Family Medicine Other name

Locations

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289865600000",
    "number": "1780698555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 MAIN ROAD",
            "city": "CORFU",
            "state": "NY",
            "postal_code": "140369753",
            "telephone_number": "585-599-6446",
            "fax_number": "585-599-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 MAIN ROAD",
            "city": "CORFU",
            "state": "NY",
            "postal_code": "140369753",
            "telephone_number": "585-599-6446",
            "fax_number": "585-599-3166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY OBEAR MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2010-11-16",
        "status": "A",
        "authorized_official_last_name": "OBEAR",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "585-599-6446",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03044906",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pembroke Family Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Peter J. Kelley, MS, FNP
• Deborah Kern, RN
• Tricia Ann Levinstein, COTA
• Karen C. Lewandowski, M.A. CCC/SLP-L
• Autumn Martin
• Leslie A. McCulloch, LMHC, ACS, NCC
• Joy Mary Mercer, LMHC
• Valerie-Lynn Anawald Mutka, LCSW-R
• Loretta Newton, RN BSN
• Oak Orchard Community Health Center, Inc.

• All providers in Corfu, NY
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.