Individual provider Active NPI

Janet A Sobczak, PHD., PMHNP-BC, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Woburn, MA
National Provider Identifier
1881921070
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN180847 Issued in MA
Practice address
12 Alfred St Ste 200
Woburn, MA 01801-1915
Phone
(781) 646-0500
Fax
(781) 646-7130
NPI assigned
Nov 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN180847 MA Primary

Addresses

Primary practice location

12 Alfred St Ste 200
Woburn, MA 01801-1915

Mailing address

7270 Buckley Rd Ste 2
Syracuse, NY 13212-2649
Phone (315) 452-0485

Other identifiers 1

IdentifierTypeStateIssuer
1336163963MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN180847MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Care Associates, P.C. CurrentSince Sep 9, 2019 Accepting new patients

Locations

22 Mill St
Ste 4
Arlington, MA 02476
Phone (781) 246-0500

12 Alfred St
Ste 200
Woburn, MA 01801
Phone 7816460500 ext. 112

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": "1257724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1881921070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7270 BUCKLEY RD STE 2",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132122649",
            "telephone_number": "315-452-0485",
            "fax_number": "315-452-0491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 ALFRED ST STE 200",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018011915",
            "telephone_number": "781-646-0500",
            "fax_number": "781-646-7130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBCZAK",
        "first_name": "JANET",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PHD., PMHNP-BC, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-09",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN180847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336163963",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.