Organization Active NPI

Jolanta Sobotka-Czarnecki MD PLLC

  • Rheumatology Physician
  • Flint, MI
National Provider Identifier
1295901288
Registry record updated Mar 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
JS060311 Issued in MI
Legal business name
JOLANTA SOBOTKA-CZARNECKI MD PLLC
Practice address
G-5085 West Bristol Rd.
Flint, MI 48507-2922
Phone
(810) 230-2400
Fax
(810) 230-1616
NPI assigned
Apr 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2015

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

Authorized official

Name
Kristen Marie Sopko
Title
Office Manager
Phone
(810) 230-1790

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RR0500X JS060311 MI Primary

Addresses

Primary practice location

G-5085 West Bristol Rd.
Flint, MI 48507-2922

Mailing address

G-5085 West Bristol Rd
Flint, MI 48507-2922
Phone (810) 230-2400

Other identifiers 7

IdentifierTypeStateIssuer
1102503161OtherMIBLUE CROSS BLUE SHIELD
5366501OtherMIAETNA
C4922OtherMIMCARE
P60832OtherMIBLUE CARE NETWORK
0989021OtherMIHEALTH PLUS
G51998OtherMIUPIN
3360475MedicaidMI

Other names 1

  • Jolanta Sobotka MD PLLC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100813000438 MI Part B Supplier - Clinic/Group Practice 0749314615 Receives reassigned benefits from 1 practitioner
Practice locations: Flint, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427414400000",
    "number": "1295901288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "G-5085 WEST BRISTOL RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485072922",
            "telephone_number": "810-230-2400",
            "fax_number": "810-230-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "G-5085 WEST BRISTOL RD.",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485072922",
            "telephone_number": "810-230-2400",
            "fax_number": "810-230-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOLANTA SOBOTKA-CZARNECKI MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-30",
        "last_updated": "2015-03-27",
        "status": "A",
        "authorized_official_last_name": "SOPKO",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "810-230-1790"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MI",
            "license": "JS060311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1102503161",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5366501",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE",
            "identifier": "C4922",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "P60832",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLUS",
            "identifier": "0989021",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "G51998",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3360475",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jolanta Sobotka MD PLLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.