Active NPI
Bruce Sobin, M.D.
- Internal Medicine Physician
- Manchester, CT
National Provider Identifier
1437160306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 017195
- Practice address
- 483 Middle Tpke W
#300
Manchester, CT 06040-3863 - Phone
- (860) 646-3814
- Fax
- (860) 649-5219
- NPI assigned
- Aug 10, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 017195 | CT | Primary |
Addresses
Primary practice location
483 Middle Tpke W
#300
Manchester, CT 06040-3863
Mailing address
4 Farm Springs Rd
Prohealth Physicians
Farmington, CT 06032-2573
Phone (860) 284-5200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017195 | CT | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prohealth Physicians PC | Internal Medicine | Past | Accepting new patients |
Organizations & group practices 1
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": "1155168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1437160306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 FARM SPRINGS RD",
"address_2": "PROHEALTH PHYSICIANS",
"city": "FARMINGTON",
"state": "CT",
"postal_code": "060322573",
"telephone_number": "860-284-5200",
"fax_number": "860-284-5333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "483 MIDDLE TPKE W",
"address_2": "#300",
"city": "MANCHESTER",
"state": "CT",
"postal_code": "060403863",
"telephone_number": "860-646-3814",
"fax_number": "860-649-5219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOBIN",
"first_name": "BRUCE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CT",
"license": "017195",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manchester, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.