NPIMap

Individual provider Active NPI

Michael Charles Hoban, D.O.

  • Cardiovascular Disease Physician
  • East Syracuse, NY
National Provider Identifier
1366893141
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
316006 Issued in NY
Practice address
4939 Brittonfield Pkwy Ste 202
East Syracuse, NY 13057-9208
Phone
(315) 634-6699
NPI assigned
Jun 23, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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 5101022274 MI
Cardiovascular Disease Physician 207RC0000X 316006 NY Primary

Addresses

Primary practice location

4939 Brittonfield Pkwy Ste 202
East Syracuse, NY 13057-9208

Mailing address

5900 Byron Center Ave SW
Wyoming, MI 49519-9606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20220530000226 NY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 0345533451 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Michigan State University College of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Medical PCGroup PAC ID 4688855844, 388 clinicians

Practice addresses (Care Compare)

4939 Brittonfield Pkwy
Suite 202
East Syracuse, NY 13057-9208
Phone (315) 634-6699

Hospital & facility affiliations

  • St Joseph'S Hospital Health Center Hospital, Syracuse, NY, CCN 330140
  • Samaritan Medical Center Hospital, Watertown, NY, CCN 330157
  • Rome Memorial Hospital, Inc Hospital, Rome, NY, CCN 330215
  • Oswego Hospital Hospital, Oswego, NY, CCN 330218
  • Wynn Hospital Hospital, Utica, NY, CCN 330044

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101022274MIMDInternal Medicine Physician
316006NYMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Medical PC Internal Medicine CurrentSince Jun 14, 2022 Accepting new patients
St Joseph'S Hospital Health Center Internal Medicine CurrentSince Jun 14, 2022 Accepting new patients
St Josephs Hospital Health Center CurrentSince Jun 14, 2022 Accepting new patients
North Medical PC Internal Medicine Current Accepting new patients

Locations

4939 Brittonfield Pkwy
Ste 202
East Syracuse, NY 13057
Phone (315) 452-2555

4000 Medical Center Dr
Ste 103
Fayetteville, NY 13066

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

301 Prospect Ave
Ofc
Syracuse, NY 13203
Phone (315) 448-2876

301 Prospect Ave
Ste 706
Syracuse, NY 13203
Phone (315) 703-5200

Interoperability endpoints

  • Direct secure messaging: mhoban2389090@direct.trinity-health.org

Organizations & group practices 4

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.

Hospital & facility affiliations 12

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": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1366893141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4939 BRITTONFIELD PKWY STE 202",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579208",
            "telephone_number": "315-634-6699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOBAN",
        "first_name": "MICHAEL",
        "middle_name": "CHARLES",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-23",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101022274",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "316006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

Verify at the official NPI Registry.