Individual provider Active NPI

John D Sobiesk, MD

  • Otolaryngology Physician
  • Hattiesburg, MS
National Provider Identifier
1508975178
Registry record updated Aug 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
14826 Issued in MS
Practice address
1605 S 28TH Ave
Hattiesburg, MS 39402-3110
Phone
(601) 579-3310
Fax
(601) 264-0231
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 14826 MS Primary

Addresses

Primary practice location

1605 S 28TH Ave
Hattiesburg, MS 39402-3110

Mailing address

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 579-3310

Other identifiers 2

IdentifierTypeStateIssuer
00116692MedicaidMS
640507572ATOtherMSAMERICAN ADMIN GROUP

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jsobiesk2445@directpatientrecord.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20080128000590 MS Practitioner - OtolaryngologyPractitioner - Allergy/Immunology 6709968852 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Allergy/Immunology
Education
Louisiana State University School of Medicine in New Orleans, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hattiesburg Clinic PAGroup PAC ID 5193706794, 525 clinicians
FGH Physician BillingGroup PAC ID 1850344946, 27 clinicians

Practice addresses (Care Compare)

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 264-6000

6051 U S Hwy 49
Hattiesburg, MS 39401-7200
Phone (601) 288-2474

Hospital & facility affiliations

  • Adoration Home Health Home health agency, Collins, MS, CCN 257087
  • Forrest General Hospital Hospital, Hattiesburg, MS, CCN 250078
  • Merit Health Wesley Hospital, Hattiesburg, MS, CCN 250094
  • Highland Community Hospital Hospital, Picayune, MS, CCN 250117
  • George Regional Health System Hospital, Lucedale, MS, CCN 250036

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision31
Removal of skin lesions13
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14826MSMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hattiesburg Clinic PA CurrentSince Oct 29, 2007 Accepting new patients
Hattiesburg Clinic, PA CurrentSince Oct 29, 2007 Accepting new patients
FGH Physician Billing CurrentSince Mar 16, 2013 Accepting new patients
Hattiesburg Clinic, PA Past Accepting new patients

Locations

6051 U S Highway 49
Hattiesburg, MS 39401
Phone (601) 288-2690

415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606

1605 S 28th Ave
Hattiesburg, MS 39402
Phone (601) 264-5684

838 Mill St
Ste D
Lucedale, MS 39452
Phone (251) 633-0573

128 Highland Pkwy
Ste 200
Picayune, MS 39466
Phone (601) 358-9630

801 Goodyear Blvd
Picayune, MS 39466
Phone (601) 749-0688

Interoperability endpoints

  • Direct secure messaging: jsobiesk2445@directpatientrecord.com

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 5

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1508975178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-579-3310",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394023110",
            "telephone_number": "601-579-3310",
            "fax_number": "601-264-0231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBIESK",
        "first_name": "JOHN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MS",
            "license": "14826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00116692",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ADMIN GROUP",
            "identifier": "640507572AT",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsobiesk2445@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1605 S 28th Ave",
            "city": "Hattiesburg",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394023110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.