Individual provider Active NPI

John Logan Sobiesk, MD

  • Otolaryngology Physician
  • Hattiesburg, MS
National Provider Identifier
1538797410
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
34922 Issued in MS
Practice address
1605 S 28TH Ave
Hattiesburg, MS 39402-3110
Phone
(601) 579-3310
Fax
(601) 264-0231
NPI assigned
Mar 27, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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 34922 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) 264-6000

Other practice location 1

534 Unadilla St
Shreveport, LA 71106-1240
Phone (601) 297-1604

Other practice location 2

533 Bolivar St Fl 5
New Orleans, LA 70112-1349
Phone (225) 757-4160

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
I20250722000658 MS Practitioner - Otolaryngology 4082036587 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Louisiana State University School of Medicine in Shreveport, 2020
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

801 Goodyear Blvd
Picayune, MS 39466-3221
Phone (601) 749-0688

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34922MSMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hattiesburg Clinic, PA CurrentSince Jul 11, 2025 Accepting new patients
FGH Physician Billing CurrentSince Jan 20, 2026 Accepting new patients
Hattiesburg Clinic PA CurrentSince Jul 11, 2025 Accepting new patients

Locations

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

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

Interoperability endpoints

  • Direct secure messaging: lsobiesk151245@directpatientrecord.com

Organizations & group practices 3

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 2

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": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1538797410",
    "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": "601-264-6000"
        },
        {
            "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": [
        {
            "address_1": "534 Unadilla St",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711061240",
            "country_code": "US",
            "telephone_number": "601-297-1604",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "533 Bolivar St Fl 5",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701121349",
            "country_code": "US",
            "telephone_number": "225-757-4160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOBIESK",
        "first_name": "JOHN",
        "middle_name": "LOGAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-27",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MS",
            "license": "34922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.