Active NPI
Bryon Sobczak, CRNA
- Certified Registered Nurse Anesthetist
- Fort Madison, IA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- D-120718
- Practice address
- 5445 Avenue O
Fort Madison, IA 52627-9611 - Phone
- (319) 376-2047
- Fax
- (319) 376-2043
- NPI assigned
- Jan 31, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 209-004904 | IL | |
| Certified Registered Nurse Anesthetist | 367500000X | D-120718 | IA | Primary |
Addresses
Primary practice location
5445 Avenue O
Fort Madison, IA 52627-9611
Mailing address
400 E 10TH St
Waconia, MN 55387-4552
Phone (952) 442-9770
Other practice location 1
3301 Broadway St
Quincy, IL 62301-3713
Phone (217) 277-4090
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3301 Broadway St
Quincy, IL 62301-3713
Phone (217) 277-3500
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D-120718 | IA | MD | Certified Registered Nurse Anesthetist |
| 209-004904 | IL | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Hospital Association | Current | Accepting new patients | |
| Memorial Hospital Association | Current | Accepting new patients | |
| St Luke'S Methodist Hospital | Current | Accepting new patients | |
| Quincy Physicians & Surgeons Clinic, PLLC | Current | Accepting new patients | |
| Quincy Physicians & Surgeons Clinic, PLLC | Current | Accepting new patients | |
| Memorial Hospital Association | Current | Accepting new patients | |
| Quincy Anesthesia Associates | Past | Accepting new patients |
Locations
1454 N County Road 2050 E
Carthage, IL 62321
Phone (217) 357-3131
1005 Broadway St
Quincy, IL 62301
1025 Maine St
Quincy, IL 62301
Phone 21722265503163
3301 Broadway St
Quincy, IL 62301
Phone (217) 277-4070
Interoperability endpoints
- bsobczak802001@direct.unitypoint.org
Organizations & group practices 7
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.
-
- Clinic/Center
- Quincy, IL
- NPI 1548234198
-
- Critical Access Hospital
- Carthage, IL
- NPI 1730139031
-
- General Acute Care Hospital
- Cedar Rapids, IA
- NPI 1083708226
-
- Rural Health Clinic/Center
- Carthage, IL
- NPI 1205887742
-
- Rural Health Clinic/Center
- Hamilton, IL
- NPI 1679327779
-
- Durable Medical Equipment & Medical Supplies
- Pittsfield, IL
- NPI 1871794925
-
- Anesthesiology Physician
- Quincy, IL
- NPI 1013023985
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621296000000",
"number": "1205973146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 E 10TH ST",
"city": "WACONIA",
"state": "MN",
"postal_code": "553874552",
"telephone_number": "952-442-9770",
"fax_number": "952-442-3630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5445 AVENUE O",
"city": "FORT MADISON",
"state": "IA",
"postal_code": "526279611",
"telephone_number": "319-376-2047",
"fax_number": "319-376-2043"
}
],
"practiceLocations": [
{
"address_1": "3301 Broadway St",
"address_purpose": "LOCATION",
"city": "Quincy",
"state": "IL",
"postal_code": "623013713",
"country_code": "US",
"telephone_number": "217-277-4090",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SOBCZAK",
"first_name": "BRYON",
"name_prefix": "Mr.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-31",
"last_updated": "2021-05-18",
"certification_date": "2021-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IL",
"license": "209-004904",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IA",
"license": "D-120718",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Madison, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.