Individual provider Active NPI

Prem Sobti, MD

  • Medical Oncology Physician
  • Cape Girardeau, MO
National Provider Identifier
1932159993
Registry record updated Mar 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
2004017430 Issued in MO
Practice address
211 Saint Francis Dr
Suite 372
Cape Girardeau, MO 63703-5049
Phone
(573) 331-5525
Fax
(573) 331-5534
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X 2004017430 MO Primary

Addresses

Primary practice location

211 Saint Francis Dr
Suite 372
Cape Girardeau, MO 63703-5049

Mailing address

PO Box 843225
Kansas City, MO 64184-3225
Phone (813) 262-8160

Other identifiers 6

IdentifierTypeStateIssuer
165777001MedicaidAR
P00302293OtherRAILROAD MEDICARE
204491OtherMOBCBS
690077OtherHEALTHLINK
6406297900MedicaidKY
206176802MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20200528001445 IL Practitioner - Hematology/Oncology 1153315411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians
Hoopeston Community Memorial HospitalGroup PAC ID 3577456037, shared by 11 NPIs, 142 clinicians

Practice addresses (Care Compare)

200 Lerna Rd S
Mattoon, IL 61938-9388
Phone (217) 258-5900

2512 Hurst Dr
Mattoon, IL 61938-9200
Phone (217) 258-5900

611 W Park St
Urbana, IL 61801-2500

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21095WVMDAdult Psychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Health Care Incorporated Medical Oncology CurrentSince May 11, 2020 Accepting new patients
Ashland Hospital Corporation Past Accepting new patients
Carle Health Care Incorporated Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Hoopeston Community Memorial Hospital Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

2512 Hurst Dr
Ste 120
Mattoon, IL 61938
Phone (217) 258-5900

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Organizations & group practices 6

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425513600000",
    "number": "1932159993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843225",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641843225",
            "telephone_number": "813-262-8160",
            "fax_number": "813-891-9066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 SAINT FRANCIS DR",
            "address_2": "SUITE 372",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035049",
            "telephone_number": "573-331-5525",
            "fax_number": "573-331-5534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBTI",
        "first_name": "PREM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2015-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "MO",
            "license": "2004017430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165777001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00302293",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "204491",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "690077",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6406297900",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206176802",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.