Jacob Bobba, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

5003 Issued in SC

Practice address

316 Calhoun St
Charleston, SC 29401-1113

Phone

(843) 720-3602

Fax

(843) 727-3602

NPI assigned

Jan 25, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, SC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Roper Saint Francis Physicians NetworkGroup PAC ID 5193874824, 530 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Roper Hospital Hospital, Charleston, SC, CCN 420087

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jbobba2482837@direct.bsmhealth.org

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.

• Roper Saint Francis Physicians Network

  • Surgery Physician
  • Charleston, SC
  • NPI 1124431606
  Medicare reassignment Care Compare group NPD
• Roper St. Francis Specialty Physicians

  • Surgery Physician
  • Ladson, SC
  • NPI 1528945912
  Medicare reassignment NPD
• Montefiore Medical Center

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1063525152
  Medicare reassignment
• Roper Saint Francis Physicians Network

  • Obstetrics & Gynecology Physician
  • Charleston, SC
  • NPI 1811857352
  NPD
• Montefiore Medical Center

  • Community/Retail Pharmacy
  • Bronx, NY
  • NPI 1194183715
  NPD
• Montefiore Medical Center

  • Family Medicine Physician
  • New York, NY
  • NPI 1760288278
  NPD
• Roper Saint Francis Physicians Network

  • Internal Medicine Physician
  • Charleston, SC
  • NPI 1013158187
  NPD (past)

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

• Roper Hospital, Inc

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1962472860
  Care Compare affiliation

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

{
    "created_epoch": "1516838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1053819946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751649",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 CALHOUN ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294011113",
            "telephone_number": "843-720-3602",
            "fax_number": "843-727-3602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBBA",
        "first_name": "JACOB",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-25",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "SC",
            "license": "5003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Denise Boan, PA-C, PHD
• Harry Wade Boatwright, M.D.
• John G Boatwright, MD
• Sarah Wade Boatwright, MD
• Alexi Madison Bobba, PA
• McKenzie Rae Bocklet
• Michael Thomas Bocklet, DMD, MSD
• Raymond Cary Bocklet, DMD, MS
• Robert Bocknek, DC
• Brooke Noelle Bode, DMD

• Surgical Physician Assistant in Charleston, SC
• Providers in Charleston, SC by specialty
• Surgical Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.