Individual provider Active NPI

Elizabeth Sobba, P.T., M.M.T.

  • Physical Therapist
  • Whitefish, MT
National Provider Identifier
1659592830
Registry record updated Aug 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1183PT Issued in NY
Practice address
333 Baker Ave
Whitefish, MT 59937-2433
Phone
(406) 212-4294
Fax
(406) 578-1271
NPI assigned
May 2, 2007
Last updated
Aug 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1183PT NY Primary

Addresses

Primary practice location

333 Baker Ave
Whitefish, MT 59937-2433

Mailing address

PO Box 1793
Whitefish, MT 59937
Phone (406) 212-4294

Other identifiers 1

IdentifierTypeStateIssuer
60951OtherMTBLUECROSS BLUESHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060310000679 MT Practitioner - Physical Therapist in Private Practice 5092722306 Practice locations: Whitefish, MT

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

333 Baker Ave
Whitefish, MT 59937-2433
Phone (406) 212-4294

PO Box
Whitefish, MT 59937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1183MTMDChiropractor
1183PTNYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1659592830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1793",
            "city": "WHITEFISH",
            "state": "MT",
            "postal_code": "59937",
            "telephone_number": "406-212-4294",
            "fax_number": "406-578-1271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 BAKER AVE",
            "city": "WHITEFISH",
            "state": "MT",
            "postal_code": "599372433",
            "telephone_number": "406-212-4294",
            "fax_number": "406-578-1271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBBA",
        "first_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "P.T., M.M.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "1183PT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "60951",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitefish, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.