Organization Active NPI

Charles F and Mark P Hobaica, PTR

  • Foot & Ankle Surgery Podiatrist
  • Utica, NY
National Provider Identifier
1952473183
Registry record updated Jul 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
003505-1 Issued in NY
Legal business name
CHARLES F AND MARK P HOBAICA, PTR
Practice address
2315 Genesee St
Utica, NY 13501-6107
Phone
(315) 735-0237
Fax
(315) 732-8695
NPI assigned
Nov 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2010

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

Authorized official

Name
Dr. Charles F Hobaica, DPM
Title
Owner
Phone
(315) 735-0237

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 003505-1 NY Primary

Addresses

Primary practice location

2315 Genesee St
Utica, NY 13501-6107

Mailing address

2315 Genesee St
Utica, NY 13501-6107
Phone (315) 735-0237

Other identifiers 2

IdentifierTypeStateIssuer
00789804MedicaidNY
00895836MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080703000312 NY Part B Supplier - Clinic/Group Practice 3274605480 Receives reassigned benefits from 1 practitioner
Practice locations: Utica, NY

National Provider Directory

National Provider Directory

Locations

2315 Genesee St
Utica, NY 13501
Phone (315) 735-0237

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280361600000",
    "number": "1952473183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 GENESEE ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135016107",
            "telephone_number": "315-735-0237",
            "fax_number": "315-732-8695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 GENESEE ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135016107",
            "telephone_number": "315-735-0237",
            "fax_number": "315-732-8695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES F AND MARK P HOBAICA, PTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2010-07-29",
        "status": "A",
        "authorized_official_last_name": "HOBAICA",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-735-0237",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "003505-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00789804",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00895836",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.