NPIMap

Individual provider Active NPI

Omar S Obeidat, MD

  • Interventional Cardiology Physician
  • Indianapolis, IN
National Provider Identifier
1942274279
Registry record updated Aug 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
01056864A Issued in IN
Practice address
1801 N Senate Blvd
Ste 310
Indianapolis, IN 46202-1196
Phone
(317) 962-2500
Fax
(317) 962-2515
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2016

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Cardiology Physician 207UN0901X 01056864 IN
Interventional Cardiology Physician 207RI0011X 01056864A IN Primary
Cardiovascular Disease Physician 207RC0000X 01056864A IN
Interventional Cardiology Physician 207RI0011X MD458745 PA
Cardiovascular Disease Physician 207RC0000X MD458745 PA
Nuclear Cardiology Physician 207UN0901X MD458745 PA

Addresses

Primary practice location

1801 N Senate Blvd
Ste 310
Indianapolis, IN 46202-1196

Mailing address

250 N Shadeland Ave
Ste 130 Provider Enrollment
Indianapolis, IN 46219-4959

Other identifiers 2

IdentifierTypeStateIssuer
P01092952OtherINRAILROAD MEDICARE PIN
200450740MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, MI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160926001545 PA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 5799754743 Reassigns benefits to 1 organization
I20210415002025 MI Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 5799754743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Physician PartnersGroup PAC ID 8921482605, 79 clinicians

Practice addresses (Care Compare)

133 S Main St
Mount Clemens, MI 48043-2308
Phone (586) 468-1600

18101 Oakwood Blvd
Dearborn, MI 48124-4089
Phone (313) 438-7880

20200 Outer Dr
Dearborn, MI 48124-2634
Phone (313) 924-8417

5450 Fort St
Trenton, MI 48183-4601
Phone (734) 642-2482

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01056864AINMDCardiovascular Disease Physician
MD458745PAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Conemaugh Physician Practices LLC Current Accepting new patients
Henry Ford Physician Partners Current Accepting new patients
Alliance Health Professionals, PLLC Current Accepting new patients
Henry Ford Physician Partners Cardiovascular Disease CurrentSince Jan 1, 2025 Accepting new patients
Internal Medicine Associates of Mt. Clemens, PC Current Accepting new patients
Henry Ford Macomb Ancillary Services Current Accepting new patients
DLP Conemaugh Physician Practices LLC Cardiovascular Disease CurrentSince Aug 25, 2018 Accepting new patients
DLP Conemaugh Physician Practices LLC CurrentSince Aug 25, 2018 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
CCCG, LLC Cardiovascular Disease Past Accepting new patients
Major Hospital Past Accepting new patients
University Medical Diagnostic Associates, Inc. Cardiovascular Disease Past Accepting new patients

Locations

20200 Outer Dr
Dearborn, MI 48124
Phone (313) 624-8417

133 S Main St
Mount Clemens, MI 48043
Phone (586) 329-1880

1111 Franklin St
Ste 180
Johnstown, PA 15905
Phone (814) 534-3740

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

1 Tech Park Dr
Ste 1120
Johnstown, PA 15901
Phone (814) 266-2434

Interoperability endpoints

  • Direct secure messaging: oobeidat@yourcarecommunity.org
  • Direct secure messaging: oobeidat721331@direct.hfhs.org
  • Direct secure messaging: omar.obeidat@hca5.eclinicaldirectplus.com

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 8

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": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471996800000",
    "number": "1942274279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "address_2": "STE 130 PROVIDER ENROLLMENT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 N SENATE BLVD",
            "address_2": "STE 310",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021196",
            "telephone_number": "317-962-2500",
            "fax_number": "317-962-2515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBEIDAT",
        "first_name": "OMAR",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2016-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "IN",
            "license": "01056864",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IN",
            "license": "01056864A",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IN",
            "license": "01056864A",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "PA",
            "license": "MD458745",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD458745",
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "PA",
            "license": "MD458745",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P01092952",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200450740",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.