Individual provider Active NPI

Gary Jay Hoberman, DPM

  • Podiatrist
  • Skokie, IL
National Provider Identifier
1609940139
Registry record updated Nov 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
016003368 Issued in IL
Practice address
4201 Davis St
Skokie, IL 60076-1601
Phone
(312) 618-1208
NPI assigned
Nov 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 016003368 IL Primary

Addresses

Primary practice location

4201 Davis St
Skokie, IL 60076-1601

Mailing address

4201 Davis St
Skokie, IL 60076-1601
Phone (312) 618-1208

Other identifiers 1

IdentifierTypeStateIssuer
016003368MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
016003368ILMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Podiatry Plus LLC Podiatrist PastSince May 1, 2015 Accepting new patients
Podiatry LTD Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668124800000",
    "number": "1609940139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 DAVIS ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761601",
            "telephone_number": "312-618-1208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 DAVIS ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761601",
            "telephone_number": "312-618-1208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOBERMAN",
        "first_name": "GARY",
        "middle_name": "JAY",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016003368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016003368",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.