Individual provider Active NPI

Bethany Marie Sobba

  • Gynecologic Oncology Physician
  • Philadelphia, PA
National Provider Identifier
1649853243
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
MT233431 Issued in PA
Practice address
333 Cottman Ave
Philadelphia, PA 19111-2497
Phone
(888) 369-2427
NPI assigned
Apr 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Gynecologic Oncology Physician 207VX0201X MT233431 PA Primary

Addresses

Primary practice location

333 Cottman Ave
Philadelphia, PA 19111-2497

Mailing address

1325 Annunciation St Apt 412
New Orleans, LA 70130-4073

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20210804001995 LA Order and Referring Only - Gynecological OncologyPractitioner - Gynecological OncologyPractitioner - Obstetrics/Gynecology 2860896487

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MT233431PAMDGynecologic Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Pharmacy and Wellness, LLC PastSince May 1, 2021 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1619740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1649853243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 ANNUNCIATION ST APT 412",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701304073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 COTTMAN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112497",
            "telephone_number": "888-369-2427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBBA",
        "first_name": "BETHANY",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-30",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "PA",
            "license": "MT233431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.