Individual provider Active NPI

Travis Roswell Hobart, MD, MPH

  • Pediatrics Physician
  • Baldwinsville, NY
National Provider Identifier
1194985606
Registry record updated Oct 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
270683 Issued in NY
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

Updated by the provider on Oct 17, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
03645681MedicaidNY

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131004000388 NY Practitioner - Pediatric MedicinePractitioner - Preventive Medicine 5597958561 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD037582DCMDPediatrics Physician
270683NYMDPublic Health & General Preventive Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Service Group Pediatrics CurrentSince Sep 1, 2013 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.