Active NPI
Travis Roswell Hobart, MD, MPH
- Pediatrics Physician
- Baldwinsville, NY
National Provider Identifier
1194985606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 270683
- Practice address
- 3448 Rte 31
Belgium Meadows
Baldwinsville, NY 13027-9231 - Phone
- (315) 622-6595
- Fax
- (315) 622-3298
- NPI assigned
- Jun 10, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | 270683 | NY | Primary |
| Public Health & General Preventive Medicine Physician | 2083P0901X | 270683 | NY | |
| Pediatrics Physician | 208000000X | MD037582 | DC |
Addresses
Primary practice location
3448 Rte 31
Belgium Meadows
Baldwinsville, NY 13027-9231
Mailing address
3448 Rte 31
Belgium Meadows
Baldwinsville, NY 13027-9231
Phone (315) 622-6595
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03645681 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD037582 | DC | MD | Pediatrics Physician |
| 270683 | NY | MD | Public Health & General Preventive Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Service Group | Pediatrics | Current | Accepting new patients |
| Suny Health Science Center at Syracuse | Past | Accepting new patients |
Locations
8687 Carling Rd
Ste C
Liverpool, NY 13090
251 Salina Meadows Pkwy
Ste 100
Syracuse, NY 13212
Phone (315) 464-2000
750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363
Interoperability endpoints
- thobart19239@direct.upstate.edu
Organizations & group practices 2
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.
-
- Pediatrics Physician
- Syracuse, NY
- NPI 1770539066
-
- Pharmacy
- Syracuse, NY
- NPI 1306567474
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381968000000",
"number": "1194985606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3448 RTE 31",
"address_2": "BELGIUM MEADOWS",
"city": "BALDWINSVILLE",
"state": "NY",
"postal_code": "130279231",
"telephone_number": "315-622-6595",
"fax_number": "315-622-3298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3448 RTE 31",
"address_2": "BELGIUM MEADOWS",
"city": "BALDWINSVILLE",
"state": "NY",
"postal_code": "130279231",
"telephone_number": "315-622-6595",
"fax_number": "315-622-3298"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOBART",
"first_name": "TRAVIS",
"middle_name": "ROSWELL",
"credential": "MD, MPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-10",
"last_updated": "2013-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "270683",
"primary": true
},
{
"code": "2083P0901X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "NY",
"license": "270683",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "DC",
"license": "MD037582",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03645681",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Baldwinsville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.