NPIMap

Individual provider Active NPI

Jacek Zdzislaw Obara, M.D.

  • Family Medicine Physician
  • Pottstown, PA
National Provider Identifier
1871715771
Registry record updated Nov 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD443274 Issued in PA
Practice address
11 Robinson St Ste 100
Community Health and Dental Care
Pottstown, PA 19464-6421
Phone
(610) 326-9460
NPI assigned
May 2, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 235325 MA
Family Medicine Physician 207Q00000X MD443274 PA Primary

Addresses

Primary practice location

11 Robinson St Ste 100
Community Health and Dental Care
Pottstown, PA 19464-6421

Mailing address

11 Robinson St
Suite 100
Pottstown, PA 19464-6421
Phone (610) 326-9460

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111130000841 PA Practitioner - Family Practice 7618042177 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenixville Clinic Company LLCGroup PAC ID 5799796850, 135 clinicians
Pottstown Clinic Company LLCGroup PAC ID 6406857184, 112 clinicians

Practice addresses (Care Compare)

140 Nutt Rd
Phoenixville, PA 19460-3906
Phone (610) 983-1000

1600 E High St
Pottstown, PA 19464-5093
Phone (610) 327-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
235325MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tower Health Medical Group Family Medicine Current Accepting new patients
Phoenixville Clinic Company LLC CurrentSince Nov 27, 2023 Accepting new patients
Tower Health Medical Group CurrentSince Nov 27, 2023 Accepting new patients
Tower Health Medical Group CurrentSince Nov 27, 2023 Accepting new patients
Pottstown Clinic Company LLC Family Medicine CurrentSince Apr 28, 2012 Accepting new patients
Phoenixville Clinic Company LLC Family Medicine Current Accepting new patients
Phoenixville Clinic Company LLC CurrentSince Nov 27, 2023 Accepting new patients
Pottstown Hospital, LLC Past Accepting new patients

Locations

8835 Germantown Ave
Philadelphia, PA 19118
Phone (215) 248-8227

140 Nutt Rd
Phoenixville, PA 19460
Phone (610) 983-1000

730 S Hanover St
Pottstown, PA 19465
Phone (610) 323-6835

1600 E High St
Pottstown, PA 19464
Phone (610) 327-7485

420 S 5th Ave
West Reading, PA 19611
Phone (484) 628-3637

2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1606/brand/1/csg/101/fhir/r4

Organizations & group practices 10

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 3

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": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321574400000",
    "number": "1871715771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 ROBINSON ST",
            "address_2": "SUITE 100",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194646421",
            "telephone_number": "610-326-9460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 ROBINSON ST STE 100",
            "address_2": "COMMUNITY HEALTH AND DENTAL CARE",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194646421",
            "telephone_number": "610-326-9460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBARA",
        "first_name": "JACEK",
        "middle_name": "ZDZISLAW",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2011-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "235325",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD443274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pottstown, PA

Sources for this page

Verify at the official NPI Registry.