NPIMap

Individual provider Active NPI

Eitan Sobel, MD

  • Internal Medicine Physician
  • Rutland, VT
National Provider Identifier
1174519698
Registry record updated Aug 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
042-0011633 Issued in VT
Practice address
160 Allen St
Rutland, VT 05701-4560
Phone
(802) 775-7111
Fax
(573) 302-2241
NPI assigned
Sep 20, 2005
Last updated
Aug 26, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 042-0011633 VT Primary
Hospitalist Physician 208M00000X 2005018610 MO

Addresses

Primary practice location

160 Allen St
Rutland, VT 05701-4560

Mailing address

160 Allen St
Rutland, VT 05701-4560

Other identifiers 4

IdentifierTypeStateIssuer
1015594MedicaidVT
01507533MedicaidNY
P00271468OtherMORAILROAD MEDICARE
207478603MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20090225000617 VT Practitioner - Internal Medicine 9234155839 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Centers of the Rutland Region IncGroup PAC ID 2961467386, shared by 9 NPIs, 103 clinicians
Rutland Hospital, Inc.Group PAC ID 7214846377, 186 clinicians

Practice addresses (Care Compare)

1 General Wing Rd
Rutland, VT 05701-4681
Phone (802) 773-9131

160 Allen St
Rutland, VT 05701-4560
Phone (802) 775-7111

215 Stratton Rd
Rutland, VT 05701-4621
Phone (802) 773-3386

275 Route 30 N
Bomoseen, VT 05732-9647
Phone (802) 468-5641

2987 VT Route 22a
Shoreham, VT 05770-9728
Phone (802) 897-7000

420 Grove St
Brandon, VT 05733-9062
Phone (802) 247-6305

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
042-0011633VTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of the Rutland Region, Inc. CurrentSince Nov 1, 2014 Accepting new patients
Rutland Hospital, Inc. CurrentSince Oct 1, 2008 Accepting new patients
Community Health Centers of the Rutland Region Inc CurrentSince Nov 1, 2014 Accepting new patients
Rutland Hospital, Inc. CurrentSince Oct 1, 2008 Accepting new patients
Community Health Centers of the Rutland Region, Inc. CurrentSince Nov 1, 2014 Accepting new patients
46 Nichols St Operations LLC Past Accepting new patients
Nine Haywood Avenue Operations LLC Past Accepting new patients
46 Nichols Street Opco LLC Past Accepting new patients
Rutland Hospital, Inc. Past Accepting new patients
Community Health Centers of the Rutland Region, Inc Past Accepting new patients
Rutland Crossings LLC Past Accepting new patients

Locations

275 VT 30 N
Bomoseen, VT 05732
Phone (802) 468-5641

420 Grove St
Brandon, VT 05733
Phone (802) 247-6305

1 General Wing Rd
Rutland, VT 05701
Phone (802) 773-9131

160 Allen St
Rutland, VT 05701

215 Stratton Rd
Rutland, VT 05701
Phone (802) 773-3386

215 Stratton Rd
#1
Rutland, VT 05701

71 Allen St
Ste 402
Rutland, VT 05701
Phone (800) 468-9118

2987 Vt Route 22A
Shoreham, VT 05770
Phone (802) 897-7000

Interoperability endpoints

  • Direct secure messaging: esobel@chcrr.medentdirect.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mountain View CenterRutland, VT, CCN 475012 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Feb 1, 2020
Jan 31, 2025
Rutland Center for Living and RehabilitationRutland, VT, CCN 475039 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Dec 18, 2024
Apr 9, 2025

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 11

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 9

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": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472169600000",
    "number": "1174519698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 ALLEN ST",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 ALLEN ST",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014560",
            "telephone_number": "802-775-7111",
            "fax_number": "573-302-2241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBEL",
        "first_name": "EITAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2016-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VT",
            "license": "042-0011633",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "2005018610",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1015594",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01507533",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00271468",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207478603",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rutland, VT

Sources for this page

Verify at the official NPI Registry.