ELIZAVETA SOUBOCH MD
NPI 1922701887
Student in an Organized Health Care Education/Training Program in San Jose, CA
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
Specialties & Licenses 2
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Elizaveta Souboch Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Elizaveta Souboch reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
San Jose, CA 95119
- Reassigned Medicare billing, California enrollment
- 101 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
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.
Which organization bills Medicare for Elizaveta Souboch's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Elizaveta Souboch reassigns Medicare benefits to Momentum For Health (San Jose, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Elizaveta Souboch's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
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 4 months 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.
# Elizaveta Souboch, MD · NPI 1922701887
Student in an Organized Health Care Education/Training Program provider in San Jose, California. Individual provider, active in the CMS NPPES registry since March 22, 2023.
## Identity
- **NPI:** 1922701887 (Entity type: Individual)
- **Enumerated:** March 22, 2023
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 250 HOSPITAL PKWY, San Jose, CA 95119-1103
- **Phone:** (408) 972-3000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Momentum For Health (NPI 1235837873, San Jose, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Illinois College Of Med, class of 2022
## Record status
- **NPPES last updated:** June 23, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1922701887) · Data from the CMS NPPES public registry.