Active NPI
Deepali Ajitkumar Bobra, M.D.
- Family Medicine Physician
- Brandon, FL
National Provider Identifier
1245444918
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME109472
- Practice address
- 1218 Millennium Parkway
Brandon, FL 33511-3895 - Phone
- (813) 684-5255
- Fax
- (813) 654-7457
- NPI assigned
- May 10, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME109472 | FL | Primary |
Addresses
Primary practice location
1218 Millennium Parkway
Brandon, FL 33511-3895
Mailing address
1218 Millennium Parkway
Brandon, FL 33511-3895
Phone (813) 684-5255
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1020386900001 | Medicaid | PA | |
| GU039851 | Other | PA | MEDICARE GROUP |
| GU039851 | Other | PA | PA MEDICARE GROUP |
| 02927237 | Medicaid | NY | |
| 003821600 | Medicaid | FL |
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
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kreider Chiropractic Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Chiropractor
- Brandon, FL
- NPI 1063823359
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417737600000",
"number": "1245444918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1218 MILLENNIUM PARKWAY",
"city": "BRANDON",
"state": "FL",
"postal_code": "335113895",
"telephone_number": "813-684-5255",
"fax_number": "813-654-7457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1218 MILLENNIUM PARKWAY",
"city": "BRANDON",
"state": "FL",
"postal_code": "335113895",
"telephone_number": "813-684-5255",
"fax_number": "813-654-7457"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOBRA",
"first_name": "DEEPALI",
"middle_name": "AJITKUMAR",
"name_prefix": "Mrs.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-10",
"last_updated": "2014-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME109472",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1020386900001",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP",
"identifier": "GU039851",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PA MEDICARE GROUP",
"identifier": "GU039851",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02927237",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003821600",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brandon, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.