Henry S Bobeck, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD036890E Issued in PA

Practice address

892 Main St
Sugar Notch, PA 18706-2015

Phone

(570) 822-6916

Fax

(570) 824-6936

NPI assigned

Jul 7, 2005

Last updated

Apr 25, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Bobeck Medical Associates

  • Internal Medicine Physician
  • Sugar Notch, PA
  • NPI 1821272147
  NPD (past) Authorized official

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398384000000",
    "number": "1013915743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 WYOMING AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187043702",
            "telephone_number": "570-288-5441",
            "fax_number": "570-288-5842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "892 MAIN ST",
            "city": "SUGAR NOTCH",
            "state": "PA",
            "postal_code": "187062015",
            "telephone_number": "570-822-6916",
            "fax_number": "570-824-6936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBECK",
        "first_name": "HENRY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2014-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175L00000X",
            "taxonomy_group": "",
            "desc": "Homeopath",
            "state": "PA",
            "license": "MD036890E",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD036890E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010621420001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bobeck Medical Associates

• Internal Medicine Physician in Sugar Notch, PA
• Providers in Sugar Notch, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.