NPIMap

Individual provider Active NPI

Jeffrey Alan Kobak, M.D.

  • Vascular & Interventional Radiology Physician
  • Poughkeepsie, NY
National Provider Identifier
1437323409
Registry record updated May 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
242709 Issued in NY
Practice address
241 North Rd
Poughkeepsie, NY 12601-1154
Phone
(845) 471-5519
Fax
(845) 471-2928
NPI assigned
Apr 21, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 242709 NY
Vascular & Interventional Radiology Physician 2085R0204X 242709 NY Primary

Addresses

Primary practice location

241 North Rd
Poughkeepsie, NY 12601-1154

Mailing address

85 Raymond Ave
104
Poughkeepsie, NY 12603-3117
Phone (845) 471-5519

Other identifiers 1

IdentifierTypeStateIssuer
03052384MedicaidNY

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
I20090604000288 NY Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 2567512015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
State University of New York Downstate Medical Center, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

241 N Rd
Poughkeepsie, NY 12601-1154
Phone (845) 483-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
242709NYMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Westchester Medical Center Advanced Physician Services, PC Vascular & Interventional Radiology CurrentSince Dec 1, 2016 Accepting new patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Dec 1, 2016 Accepting new patients
Valley Interventional Medical Associates, PLLC PastSince Mar 15, 2012 Accepting new patients
Israel Schur MD PLLC Vascular & Interventional Radiology PastSince Feb 1, 2020 Accepting new patients
Mid- Hudson Medical Group P C Past Accepting new patients
Radiology Associates of Poughkeepsie PLLC Diagnostic Radiology Past Accepting new patients

Locations

60 Merritt Blvd
Ste 107
Fishkill, NY 12524
Phone (845) 896-1900

241 North Rd
Poughkeepsie, NY 12601
Phone (845) 431-8889

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Organizations & group practices 6

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 4

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": "1208736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336521600000",
    "number": "1437323409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 RAYMOND AVE",
            "address_2": "104",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126033117",
            "telephone_number": "845-471-5519",
            "fax_number": "845-471-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 NORTH RD",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126011154",
            "telephone_number": "845-471-5519",
            "fax_number": "845-471-2928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBAK",
        "first_name": "JEFFREY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-21",
        "last_updated": "2012-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "242709",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NY",
            "license": "242709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03052384",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.