Individual provider Active NPI

Regina Marie Sobojinski, PT

  • Physical Therapist
  • Oshkosh, WI
National Provider Identifier
1720053747
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3887-024 Issued in WI
Practice address
909 S Washburn St
Oshkosh, WI 54904-8051
Phone
(920) 235-8966
Fax
(920) 235-1526
NPI assigned
Feb 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 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 3887-024 WI Primary

Addresses

Primary practice location

909 S Washburn St
Oshkosh, WI 54904-8051

Mailing address

909 S Washburn St
Oshkosh, WI 54904-8051
Phone (920) 235-8966

Other identifiers 1

IdentifierTypeStateIssuer
40171400MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040720000878 WI Practitioner - Physical Therapist in Private Practice 5799765988 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Valley Physical Therapy and Wellness Clinic IncGroup PAC ID 9638155732, 3 clinicians

Practice addresses (Care Compare)

909 S Washburn St
Oshkosh, WI 54904-8051
Phone (920) 235-8966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3887-024WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Valley Physical Therapy & Wellness Clinic, Inc. Physical Therapist CurrentSince Mar 1, 2000 Accepting new patients

Locations

909 S Washburn St
Oshkosh, WI 54904
Phone (920) 235-8966

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1720053747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 S WASHBURN ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549048051",
            "telephone_number": "920-235-8966",
            "fax_number": "920-235-1526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 S WASHBURN ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549048051",
            "telephone_number": "920-235-8966",
            "fax_number": "920-235-1526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBOJINSKI",
        "first_name": "REGINA",
        "middle_name": "MARIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-22",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "3887-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40171400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.