NPIMap

Individual provider Active NPI

Pratyush Bobba

  • Family Medicine Physician
  • Chino, CA
National Provider Identifier
1093378549
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD61436847 Issued in WA
Practice address
5451 Walnut Ave
Chino, CA 91710-2609
Phone
(909) 464-8600
NPI assigned
Apr 19, 2019
Last updated
Jul 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X MD61436847 WA Primary

Addresses

Primary practice location

5451 Walnut Ave
Chino, CA 91710-2609

Mailing address

5451 Walnut Ave
Chino, CA 91710-2609

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230807001895 WA Practitioner - Family Practice 7315362654 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Post Acute Medical PLLCGroup PAC ID 5193156115, 433 clinicians

Practice addresses (Care Compare)

16251 Sylvester Rd SW
Burien, WA 98166-3017
Phone (206) 244-9970

17700 SE 272ND St
Covington, WA 98042-4951
Phone (253) 372-6500

202 N Division St
Auburn, WA 98001-4939
Phone (253) 833-7711

315 Martin Luther King Jr Way
Tacoma, WA 98405-4234
Phone (253) 403-1000

407 14TH Ave SE
Puyallup, WA 98372-3770
Phone (253) 697-4000

9827 N Nevada St
Spokane, WA 99218-3407
Phone (855) 722-9700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Inpatient Physicians PLLC Family Medicine CurrentSince Jul 1, 2023 Accepting new patients
South Sound Inpatient Physicians PLLC Family Medicine CurrentSince Jul 1, 2023 Accepting new patients
Altea Medical Washington PLLC CurrentSince Nov 1, 2025 Accepting new patients
Post Acute Medical PLLC CurrentSince Aug 25, 2025 Accepting new patients
Multicare Health System Past Accepting new patients
Southwest 2ND Street Healthcare LLC Past Accepting new patients
Kuancheng Chen MD Corp PastSince May 3, 2010 Accepting new patients

Locations

400 E Rivulon Blvd
Ste 103
Gilbert, AZ 85297

414 17th St SE
Auburn, WA 98002
Phone (253) 320-0748

303 Telegraph Rd
Bellingham, WA 98226
Phone (360) 863-6696

16251 Sylvester Rd SW
Burien, WA 98166
Phone (206) 244-9970

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

2821 S Walden St
Seattle, WA 98144
Phone (206) 577-6200

6025 N Assembly St
Spokane, WA 99205
Phone (509) 326-8282

9827 N Nevada St
Spokane, WA 99218
Phone (509) 468-7000

6220 S Alaska St
Tacoma, WA 98408
Phone (253) 473-2273

Interoperability endpoints

  • Direct secure messaging: pbobba577534@direct.llu.edu

Organizations & group practices 7

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1555632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1093378549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5451 WALNUT AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917102609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5451 WALNUT AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917102609",
            "telephone_number": "909-464-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBBA",
        "first_name": "PRATYUSH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-19",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61436847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino, CA

Sources for this page

Verify at the official NPI Registry.