Individual provider Active NPI

Gwen Elizabeth Hobson

  • Adult Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1730504663
Registry record updated Mar 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F306539-1 Issued in NY
Practice address
525 E 68TH St
New York, NY 10065-4870
Phone
(212) 746-5026
NPI assigned
Mar 1, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F306539-1 NY Primary

Addresses

Primary practice location

525 E 68TH St
New York, NY 10065-4870

Mailing address

17 Thomas PL
New Rochelle, NY 10801-2407
Phone (914) 980-3188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140805000724 NY Practitioner - Nurse Practitioner 9032336714 Reassigns benefits to 1 organization
I20200804000551 TX Practitioner - Nurse Practitioner 9032336714 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F306539-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tanana Chiefs Conference CurrentSince Jul 1, 2020 Accepting new patients
Dobbs Ferry Emergency Medicine, PC CurrentSince Sep 22, 2022 Accepting new patients
Tanana Chiefs Conference CurrentSince Jul 1, 2020 Accepting new patients
Clearchoicemd Primary Care PLLC Past Accepting new patients

Locations

1717 W Cowles St
Fairbanks, AK 99701
Phone (907) 452-6682

128 Ashford Ave
Dobbs Ferry, NY 10522
Phone (914) 245-8936

Interoperability endpoints

  • Direct secure messaging: gwen.hobson.1@15989.direct.athenahealth.com

Organizations & group practices 4

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": "1393632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393632000000",
    "number": "1730504663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 THOMAS PL",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108012407",
            "telephone_number": "914-980-3188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E 68TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654870",
            "telephone_number": "212-746-5026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOBSON",
        "first_name": "GWEN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-01",
        "last_updated": "2014-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F306539-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.