Active NPI
Philip Gregory Bohart, M.D
- Orthopaedic Surgery Physician
- Poway, CA
National Provider Identifier
1033223425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- G28742
- Practice address
- 15525 Pomerado Rd
Suite a-1
Poway, CA 92064-2435 - Phone
- (858) 485-0050
- Fax
- (858) 485-9510
- NPI assigned
- Aug 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | G28742 | CA | Primary |
Addresses
Primary practice location
15525 Pomerado Rd
Suite a-1
Poway, CA 92064-2435
Mailing address
15525 Pomerado Rd
Suite a-1
Poway, CA 92064-2435
Phone (858) 485-0050
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G287420 | Medicaid | CA |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G28742 | CA | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636070400000",
"number": "1033223425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15525 POMERADO RD",
"address_2": "SUITE A-1",
"city": "POWAY",
"state": "CA",
"postal_code": "920642435",
"telephone_number": "858-485-0050",
"fax_number": "858-485-9510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15525 POMERADO RD",
"address_2": "SUITE A-1",
"city": "POWAY",
"state": "CA",
"postal_code": "920642435",
"telephone_number": "858-485-0050",
"fax_number": "858-485-9510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOHART",
"first_name": "PHILIP",
"middle_name": "GREGORY",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-19",
"last_updated": "2021-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "CA",
"license": "G28742",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G287420",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Poway, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.