Individual provider Active NPI

Melvin T. Bobo, LISW

  • Social Worker
  • Des Moines, IA
National Provider Identifier
1063617355
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
06383 Issued in IA
Practice address
1801 Hickman Rd
Des Moines, IA 50314-1548
Phone
(515) 282-2200
Fax
(515) 282-3234
NPI assigned
Jun 18, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 06383 IA Primary

Addresses

Primary practice location

1801 Hickman Rd
Des Moines, IA 50314-1548

Mailing address

1801 Hickman Rd
Des Moines, IA 50314-1548
Phone (515) 282-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070918000048 IA Practitioner - Clinical Social Worker 9537253828 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Compass Clinical Associates PLLCGroup PAC ID 2062648017, 25 clinicians

Practice addresses (Care Compare)

2500 82ND PL
Urbandale, IA 50322-4329
Phone (515) 412-5112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Broadlawns Medical Center CurrentSince Jun 11, 2007 Accepting new patients
Compass Clinical Associates PLLC Social Worker CurrentSince Feb 3, 2020 Accepting new patients
Broadlawns Medical Center CurrentSince Jun 11, 2007 Accepting new patients

Locations

1801 Hickman Rd
Des Moines, IA 50314
Phone (515) 282-2200

2500 82nd Pl
Urbandale, IA 50322
Phone (515) 270-1344

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063617355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 HICKMAN RD",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503141548",
            "telephone_number": "515-282-2200",
            "fax_number": "515-282-3234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 HICKMAN RD",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503141548",
            "telephone_number": "515-282-2200",
            "fax_number": "515-282-3234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBO",
        "first_name": "MELVIN",
        "middle_name": "T.",
        "name_prefix": "Mr.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IA",
            "license": "06383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.