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SARMAD TAREQ IBRAHEEM AL OBAIDI MD
NPI 1780387662
Student in an Organized Health Care Education/Training Program in Port Jefferson, NY

Active since March 22, 2023PECOS Enrolled
75 N COUNTRY RD, PORT JEFFERSON, NY 11777(631) 473-1320 Get Directions Write a Review

NPPES record last updated: March 22, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Sarmad Tareq Ibraheem Al Obaidi Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SARMAD TAREQ IBRAHEEM AL OBAIDI MD (NPI 1780387662) is an individual student in an organized health care education/training program in Port Jefferson, New York and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1780387662
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameSARMAD TAREQ IBRAHEEM AL OBAIDICredential: MD
Location Address75 N COUNTRY RDPort Jefferson, NY 11777-2119
Mailing Address75 N Country RdPort Jefferson, NY 11777-2119 · (631) 473-1320
Phone(631) 473-1320
Sole ProprietorYes
Medical School CMSOtherGraduated 2017
Enumeration DateMarch 22, 2023
NPPES CertifiedMarch 22, 2023
✔ NPI 1780387662 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
75 N COUNTRY RD, Port Jefferson, NY 11777
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sarmad Tareq Ibraheem Al Obaidi Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7416414594
PECOS Enrollment IDI20260807004396
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Sarmad Al Obaidi reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Florida Hospital Physician Group Inc
1,034 mi
Family Medicine
3000 MEDICAL PARK DR, STE 320
Tampa, FL 33613
  • Reassigned Medicare billing, Florida enrollment
  • 1,719 clinicians in this Medicare group
NPI 1174955256 (813) 336-5766

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JUSTINA CATHERINE MELLONE DO
Student in an Organized Health Care Education/Training Program
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 473-1320
AAKAASH VARMA MD
Dermatology
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 686-2549
KRISELA VOJNIKU MD
Student in an Organized Health Care Education/Training Program
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 686-2549
LORETTA DIDWELL
Physician Assistant
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 473-1320
RAYMOND WONG
Internal Medicine
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 686-7654
JULIA KOROBENKO DO
Student in an Organized Health Care Education/Training Program
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 686-2549
KATHLEEN FANELLI
Nurse Practitioner (Acute Care)
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 473-1320
BENJAMIN O'BRIEN
Student in an Organized Health Care Education/Training Program
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 473-1320

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sarmad Al Obaidi's NPI number?

The NPI number for Sarmad Al Obaidi is 1780387662. It was assigned to this individual provider in the NPPES registry on March 22, 2023.

Where is Sarmad Al Obaidi located?

Sarmad Al Obaidi practices at 75 N Country Rd, Port Jefferson, NY 11777. The listed phone number is (631) 473-1320.

What is Sarmad Al Obaidi's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Sarmad Al Obaidi enrolled in Medicare?

Yes. Sarmad Al Obaidi is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Sarmad Al Obaidi's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sarmad Al Obaidi reassigns Medicare benefits to Florida Hospital Physician Group Inc (Tampa, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Sarmad Al Obaidi's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sarmad Al Obaidi accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Sarmad Al Obaidi as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Sarmad Al Obaidi was last updated on March 22, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.