Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

ELIZAVETA SOUBOCH MD
NPI 1922701887
Student in an Organized Health Care Education/Training Program in San Jose, CA

Active since March 22, 2023PECOS Enrolled
250 HOSPITAL PKWY, SAN JOSE, CA 95119(408) 972-3000 Get Directions Write a Review

NPPES record last updated: June 23, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 13, 2026, Mar 22, 2023 (2 updates tracked since 2023).

About Elizaveta Souboch Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELIZAVETA SOUBOCH MD (NPI 1922701887) is an individual student in an organized health care education/training program in San Jose, California and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS, maintains a secondary practice location in San Jose, and is a graduate of University Of Illinois College Of Med (chi/peor/rock/chm-urb) (2022).

NPPES Registry Identity

NPI1922701887
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameELIZAVETA SOUBOCHCredential: MD
Location Address250 HOSPITAL PKWYSan Jose, CA 95119-1103
Mailing Address250 Hospital PkwySan Jose, CA 95119-1103
Sole ProprietorNo
Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 2022
Enumeration DateMarch 22, 2023
Last NPPES UpdateJune 23, 20262 updates tracked since enumeration
NPPES CertifiedJune 23, 2026
NPI 1922701887 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Also ListedIntegrative MedicineTaxonomy 202D00000X · License A199597 (CA)
250 HOSPITAL PKWY, San Jose, CA 95119

Secondary Practice Location 1

Location 11922 The AlamedaSan Jose, CA 95126-1457 · Phone (408) 261-7777

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Elizaveta Souboch Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4789121559
PECOS Enrollment IDI20260608001935
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapist
250 HOSPITAL PKWY
SAN JOSE, CA 95119
Internal Medicine
250 HOSPITAL PKWY, 260 INTERNATIONAL CIRCLE
SAN JOSE, CA 95119
Physical Therapist
250 HOSPITAL PKWY
SAN JOSE, CA 95119
Psychiatry & Neurology (Psychiatry)
250 HOSPITAL PKWY
SAN JOSE, CA 95119
Family Medicine
250 HOSPITAL PKWY
SAN JOSE, CA 95119
Pharmacist
250 HOSPITAL PKWY
SAN JOSE, CA 95119
Anesthesiology (Pain Medicine)
250 HOSPITAL PKWY
SAN JOSE, CA 95119
Pharmacist (Psychiatric)
250 HOSPITAL PKWY
SAN JOSE, CA 95119

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Elizaveta Souboch's NPI number?

The NPI number for Elizaveta Souboch is 1922701887. It was assigned to this individual provider in the NPPES registry on March 22, 2023.

Where is Elizaveta Souboch located?

Elizaveta Souboch practices at 250 Hospital Pkwy, San Jose, CA 95119. The listed phone number is (408) 972-3000.

What is Elizaveta Souboch's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Elizaveta Souboch enrolled in Medicare?

Yes. Elizaveta Souboch is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Elizaveta Souboch was last updated on June 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 54 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.