Bruce Louis Bobek, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

DO16469 Issued in OR

Practice address

1615 Delaware St
Longview, WA 98632-2367

Phone

(360) 501-3601

Fax

(360) 501-3648

NPI assigned

Oct 28, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OR, WA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/bea62b1d-5b0c-4c1a-bdbd-eaa129312421/
• Direct secure messaging: bbobek10927@direct.lhs.org
• Direct secure messaging: bbobek457221@direct.peacehealth.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.

• Bay Clinic

  • Specialist
  • Coos Bay, OR
  • NPI 1538174958

  OR

  Medicare reassignment NPD
• Good Shepherd Health Care System

  • Critical Access Hospital
  • Hermiston, OR
  • NPI 1295789667

  OR

  Medicare reassignment NPD
• Mid-Columbia Medical Center

  • General Practice Physician
  • The Dalles, OR
  • NPI 1053409599

  OR

  Medicare reassignment NPD
• Northwest Medical Foundation of Tillamook

  • Critical Access Hospital
  • Tillamook, OR
  • NPI 1871575225

  OR

  Medicare reassignment NPD
• Good Shepherd Health Care System

  • Pediatrics Physician
  • Hermiston, OR
  • NPI 1336198159
  NPD
• Northwest Medical Foundation of Tillamook

  • Critical Access Hospital
  • Sheridan, OR
  • NPI 1053873919
  NPD
• Northwest Medical Foundation of Tillamook

  • Rural Health Clinic/Center
  • Vernonia, OR
  • NPI 1285164921
  NPD
• Banner-University Medical Group

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1508809427

  Family Medicine

  NPD (past)
• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)
• Mid-Columbia Medical Center

  • Rural Health Clinic/Center
  • The Dalles, OR
  • NPI 1154351336

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1225028343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 THOMPSON RD",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202100",
            "telephone_number": "503-325-5411",
            "fax_number": "503-325-3711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 DELAWARE ST",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322367",
            "telephone_number": "360-501-3601",
            "fax_number": "360-501-3648"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "515 15th St",
            "address_purpose": "LOCATION",
            "city": "Astoria",
            "state": "OR",
            "postal_code": "971033812",
            "country_code": "US",
            "telephone_number": "503-325-5411",
            "fax_number": "503-325-3711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOBEK",
        "first_name": "BRUCE",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "OP60928203",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "DO16469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009204",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "226945",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bonnie Bloesser
• Danyelle Bloomstrom, REGISTERED DIETITIAN
• Tracey Joanne Bluhm, PTA
• Nichole E Boaglio, BA, AAC
• Melanie Katherine Bobbs, MD
• Janey Bochart
• Lane Bodenhamer
• Destinee Boggs, R-AAC, CPC
• Gable Aaron Bogner, PT, DPT
• Bryan A Bohling, M.D.

• All providers in Longview, WA
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.