NPIMap

Individual provider Active NPI

Benjamin Holobowicz Jr., PAC

  • Physician Assistant
  • Newport, NH
National Provider Identifier
1124066642
Registry record updated Jul 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0433P Issued in NH
Practice address
11 John Stark Hwy
Newport, NH 03773
Phone
(603) 863-4100
Fax
(603) 863-3585
NPI assigned
Jun 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0550030828 VT
Medical Physician Assistant 363AM0700X 0433P NH
Physician Assistant 363A00000X 0433P NH Primary

Addresses

Primary practice location

11 John Stark Hwy
Newport, NH 03773

Mailing address

11 John Stark Hwy
Newport, NH 03773-1807
Phone (603) 863-4100

Other practice location 1

25 Ridgewood Road
Springfield Emergency Dept
Springfield, VT 05156
Phone (802) 885-2151

Other practice location 2

25 Ridgewood Road
Springfield Emergency Dept
Springfield, VT 05156
Phone (802) 885-2151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20051123000579 NH Practitioner - Physician Assistant 9830119528 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The New London Hospital Association IncGroup PAC ID 5294643623, 66 clinicians

Practice addresses (Care Compare)

11 John Stark Hwy
Newport, NH 03773-1807
Phone (603) 526-5215

Hospital & facility affiliations

  • Lake Sunapee Home Care & Hospice Home health agency, New London, NH, CCN 307040
  • Bayada Home Health Care Inc. Home health agency, Londonderry, NH, CCN 307098
  • New London Hospital Hospital, New London, NH, CCN 301304
  • Valley Regional Hospital Hospital, Claremont, NH, CCN 301308
  • Mary Hitchcock Memorial Hospital Hospital, Lebanon, NH, CCN 300003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0550030828VTMDPhysician Assistant
0433PNHMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sunapee Harbor Health LLC Physician Assistant CurrentSince Jul 1, 2026 Accepting new patients
The New London Hospital Association, Inc. Current Accepting new patients
The New London Hospital Association, Inc. CurrentSince Oct 15, 2023 Accepting new patients
Springfield Medical Care Systems Inc CurrentSince Feb 15, 2022 Accepting new patients

Locations

250 Ceda Rd
Charlestown, NH 03603
Phone (603) 826-5711

273 County Rd
New London, NH 03257
Phone (603) 526-5215

11 John Stark Hwy
Newport, NH 03773
Phone (603) 526-5203

6 Holmes Ln
Sunapee, NH 03782
Phone (603) 384-3684

1 Hospital Ct
Bellows Falls, VT 05101
Phone (802) 463-1292

25 Ridgewood Rd
Springfield, VT 05156
Phone (780) 281-9593

Organizations & group practices 6

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.

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": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530489600000",
    "number": "1124066642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 JOHN STARK HWY",
            "city": "NEWPORT",
            "state": "NH",
            "postal_code": "037731807",
            "telephone_number": "603-863-4100",
            "fax_number": "603-863-3585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 JOHN STARK HWY",
            "city": "NEWPORT",
            "state": "NH",
            "postal_code": "03773",
            "telephone_number": "603-863-4100",
            "fax_number": "603-863-3585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Ridgewood Road",
            "address_2": "Springfield Emergency Dept",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "VT",
            "postal_code": "05156",
            "country_code": "US",
            "telephone_number": "802-885-2151",
            "fax_number": "802-885-7555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25 Ridgewood Road",
            "address_2": "Springfield Emergency Dept",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "VT",
            "postal_code": "05156",
            "country_code": "US",
            "telephone_number": "802-885-2151",
            "fax_number": "802-885-7555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLOBOWICZ",
        "first_name": "BENJAMIN",
        "name_suffix": "Jr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2018-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VT",
            "license": "0550030828",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NH",
            "license": "0433P",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "0433P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, NH

Sources for this page

Verify at the official NPI Registry.