Individual provider Active NPI

Mary Kobak, MD

  • Family Medicine Physician
  • Newark, DE
National Provider Identifier
1790763696
Registry record updated Jul 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C10003064 Issued in DE
Practice address
200 Hygeia Dr
Newark, DE 19713-2049
Phone
(302) 623-0100
Fax
(302) 623-0147
NPI assigned
Jan 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C10003064 DE Primary

Addresses

Primary practice location

200 Hygeia Dr
Newark, DE 19713-2049

Mailing address

PO Box 30170
Wilmington, DE 19805-7170
Phone (302) 623-0100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20050729000925 DE Practitioner - Family Practice 6103854294 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services, Inc Current Accepting new patients
Christiana Care Health Services, Inc Family Medicine CurrentSince Jul 1, 2005 Accepting new patients
Christiana Care Health Services Inc CurrentSince Jul 1, 2005 Accepting new patients

Locations

726 Yorklyn Rd
Ste 100
Hockessin, DE 19707
Phone (302) 234-5770

200 Hygeia Dr
Newark, DE 19713
Phone (302) 273-1701

4735 Ogletown Stanton Rd
Ste 1250
Newark, DE 19713
Phone (302) 623-0200

200 Hygeia Dr
Ste 2400
Newark, DE 19713
Phone (302) 623-0100

3105 Limestone Rd
Ste 200
Wilmington, DE 19808
Phone (302) 366-7665

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217462400000",
    "number": "1790763696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30170",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198057170",
            "telephone_number": "302-623-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HYGEIA DR",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132049",
            "telephone_number": "302-623-0100",
            "fax_number": "302-623-0147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBAK",
        "first_name": "MARY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-03",
        "last_updated": "2008-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DE",
            "license": "C10003064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.