Individual provider Active NPI

Judith Sobowale, MD

  • Infectious Disease Physician
  • Rochester, NY
National Provider Identifier
1457369126
Registry record updated Jan 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
188330 Issued in NY
Practice address
800 Carter St
Rochester, NY 14621-2604
Phone
(585) 338-1400
Fax
(585) 339-9442
NPI assigned
Aug 4, 2006
Last updated
Jan 7, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2010

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 188330 NY
Infectious Disease Physician 207RI0200X 188330 NY Primary

Addresses

Primary practice location

800 Carter St
Rochester, NY 14621-2604

Mailing address

800 Carter St
C/O Credentialing Department
Rochester, NY 14621-2604
Phone (585) 336-4858

Other identifiers 1

IdentifierTypeStateIssuer
01668102MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061226000079 NY Practitioner - Internal Medicine 6709886773 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
188330NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upper Room AIDS Ministry, Inc. Adult Day Health Care Center. CurrentSince Dec 8, 2020 Accepting new patients
Shlomit Levy PastSince Dec 8, 2020 Accepting new patients
North General Physician Services PLLC Internal Medicine PastSince Jul 1, 2006 Accepting new patients
MVP Medical Practice PC Infectious Disease Past Accepting new patients

Locations

169 W 133rd St
New York, NY 10030
Phone (646) 762-4950

306 Malcolm X Blvd
Fl 3
New York, NY 10027
Phone (212) 803-2850

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262822400000",
    "number": "1457369126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 CARTER ST",
            "address_2": "C/O CREDENTIALING DEPARTMENT",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146212604",
            "telephone_number": "585-336-4858",
            "fax_number": "585-336-4845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 CARTER ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146212604",
            "telephone_number": "585-338-1400",
            "fax_number": "585-339-9442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBOWALE",
        "first_name": "JUDITH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2010-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "188330",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NY",
            "license": "188330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01668102",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.