Individual provider Active NPI

David John Bobiak, ARNP/CRNA

  • Certified Registered Nurse Anesthetist
  • Bremerton, WA
National Provider Identifier
1073511515
Registry record updated Jan 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP30005417 Issued in WA
Practice address
990 Sylvan Way
Bremerton, WA 98310-2851
Phone
(360) 479-3657
Fax
(360) 373-7616
NPI assigned
Jul 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP30005417 WA Primary

Addresses

Primary practice location

990 Sylvan Way
Bremerton, WA 98310-2851

Mailing address

990 Sylvan Way
Bremerton, WA 98310-2851
Phone (360) 479-3657

Other identifiers 9

IdentifierTypeStateIssuer
7215BOOtherWAREGENCE BLUE SHIELD
0159563OtherWALABOR AND INDUSTRIES
910847215OtherWATRIWEST
910847215OtherWAUNIFORM MEDICAL
016487001OtherWAGROUP HEALTH CORP
430070634OtherWARAILROAD MEDICARE
910847215OtherWAPREMERA BLUE CROSS
910847215-33OtherWAKPS
9612557MedicaidWA

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232496000000",
    "number": "1073511515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 SYLVAN WAY",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983102851",
            "telephone_number": "360-479-3657",
            "fax_number": "360-373-7616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 SYLVAN WAY",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983102851",
            "telephone_number": "360-479-3657",
            "fax_number": "360-373-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBIAK",
        "first_name": "DAVID",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "ARNP/CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2009-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP30005417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "7215BO",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0159563",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIWEST",
            "identifier": "910847215",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIFORM MEDICAL",
            "identifier": "910847215",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH CORP",
            "identifier": "016487001",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "430070634",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA BLUE CROSS",
            "identifier": "910847215",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KPS",
            "identifier": "910847215-33",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9612557",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.