Individual provider Active NPI

Jennifer Enuka Obiadi, MD

  • Internal Medicine Physician
  • Laurel, MD
National Provider Identifier
1922265529
Registry record updated Jun 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D68005 Issued in MD
Practice address
14207 Park Center Dr
Suite 102
Laurel, MD 20707
Phone
(301) 604-5254
Fax
(410) 367-2093
NPI assigned
May 21, 2008
Last updated
Jun 1, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2018

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 D68005 MD Primary

Addresses

Primary practice location

14207 Park Center Dr
Suite 102
Laurel, MD 20707

Mailing address

9910 Franklin Square Dr # 2110
Baltimore, MD 21236-4902
Phone (410) 933-5412

Other practice location 1

14207 Park Center Dr
Suite 102
Laurel, MD 20707-5248
Phone (301) 604-5254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090114000113 DC Practitioner - Internal Medicine 0648333898 Reassigns benefits to 2 organizations
I20150601000684 MD Practitioner - Internal Medicine 0648333898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

1145 19TH St NW
311 MMG at 19TH Street NW
Washington, DC 20036-3735
Phone (202) 429-2401

13952 Baltimore Ave
Laurel, MD 20707-5000
Phone (301) 490-1990

1805 Columbia Rd NW
MMG Adams Morgan
Washington, DC 20009-2001
Phone (202) 797-4950

3007 Tilden St NW
Suite 5N
Washington, DC 20008-3030

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins Community Physicians, Inc Internal Medicine CurrentSince Sep 8, 2015 Accepting new patients
Johns Hopkins Community Physicians Internal Medicine CurrentSince Sep 8, 2015 Accepting new patients
Johns Hopkins Community Physicians, Inc Internal Medicine CurrentSince Sep 8, 2015 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

5255 Loughboro Rd NW
Washington, DC 20016
Phone (202) 243-2280

1000 E Eager St
Baltimore, MD 21202
Phone (410) 522-9800

5755 Cedar Ln
Columbia, MD 21044
Phone (410) 381-7171

14207 Park Center Dr
Ste 102
Laurel, MD 20707
Phone (301) 604-5254

9910 Franklin Square Dr
#2110
Nottingham, MD 21236
Phone (410) 933-5412

1500 Forest Glen Rd
Silver Spring, MD 20910
Phone (301) 754-7230

Interoperability endpoints

  • Direct secure messaging: jennifer.obiadimd.p2@direct.msmg.nextgenshare.com

Organizations & group practices 5

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 2

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": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527811200000",
    "number": "1922265529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9910 FRANKLIN SQUARE DR # 2110",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212364902",
            "telephone_number": "410-933-5412",
            "fax_number": "410-933-1390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14207 PARK CENTER DR",
            "address_2": "SUITE 102",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "20707",
            "telephone_number": "301-604-5254",
            "fax_number": "410-367-2093"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14207 Park Center Dr",
            "address_2": "Suite 102",
            "address_purpose": "LOCATION",
            "city": "Laurel",
            "state": "MD",
            "postal_code": "207075248",
            "country_code": "US",
            "telephone_number": "301-604-5254",
            "fax_number": "410-367-2093",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OBIADI",
        "first_name": "JENNIFER",
        "middle_name": "ENUKA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2018-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D68005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

Verify at the official NPI Registry.