Individual provider Active NPI

David Michael Shobin, MD

  • Gynecology Physician
  • Smithtown, NY
National Provider Identifier
1467560763
Registry record updated Oct 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
10611 Issued in NY
Practice address
498 RT 11
Smithtown, NY 11787-4732
Phone
(631) 724-6224
Fax
(631) 724-6282
NPI assigned
Aug 27, 2006
Last updated
Oct 15, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 10611 NY Primary

Addresses

Primary practice location

498 RT 11
Smithtown, NY 11787-4732

Mailing address

498 RT 11
Smithtown, NY 11787-4732
Phone (631) 724-6224

Other identifiers 1

IdentifierTypeStateIssuer
00708416MedicaidNY

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
I20090414000567 NY Practitioner - Obstetrics/Gynecology 0042367864 Practice locations: Smithtown, NY

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10611NYMDGynecology Physician

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, 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": "1156636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255564800000",
    "number": "1467560763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "498 RT 11",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117874732",
            "telephone_number": "631-724-6224",
            "fax_number": "631-724-6282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "498 RT 11",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117874732",
            "telephone_number": "631-724-6224",
            "fax_number": "631-724-6282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOBIN",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-27",
        "last_updated": "2009-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NY",
            "license": "10611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00708416",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.