Individual provider Active NPI

Brijesh Bobba, MD

  • Hospitalist Physician
  • Phoenix, AZ
National Provider Identifier
1326145210
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
35785 Issued in AZ
Practice address
9201 W Thomas Rd
Phoenix, AZ 85037-3332
Phone
(623) 327-7313
Fax
(623) 327-5437
NPI assigned
Sep 20, 2006
Last updated
Aug 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 35785 AZ Primary
Internal Medicine Physician 207R00000X 35785 AZ

Addresses

Primary practice location

9201 W Thomas Rd
Phoenix, AZ 85037-3332

Mailing address

13640 N Plaza del Rio Blvd
Peoria, AZ 85381-4846
Phone (623) 876-3800

Other identifiers 2

IdentifierTypeStateIssuer
159825MedicaidAZ
P00366089OtherAZRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20070103000308 AZ Practitioner - Internal Medicine 1254331978 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35785AZMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Physician Specialists Arizona LLC CurrentSince Feb 1, 2012 Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince May 1, 2014 Accepting new patients
Banner Hospital Based Physicians Arizona LLC Current Accepting new patients
Banner Physician Specialists Arizona LLC Current Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Feb 1, 2012 Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince May 1, 2014 Accepting new patients

Locations

5555 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 588-5555

807 S Ponderosa St
Payson, AZ 85541
Phone (520) 474-3222

13640 N Plaza del Rio Blvd
Peoria, AZ 85381
Phone (623) 876-3800

13760 N 93rd Ave
Ste 107
Peoria, AZ 85381
Phone (623) 876-3952

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

9201 W Thomas Rd
Phoenix, AZ 85037
Phone (623) 327-4000

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

14502 W Meeker Blvd
Sun City West, AZ 85375
Phone (623) 214-4000

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1326145210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13640 N PLAZA DEL RIO BLVD",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814846",
            "telephone_number": "623-876-3800",
            "fax_number": "623-876-6965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9201 W THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850373332",
            "telephone_number": "623-327-7313",
            "fax_number": "623-327-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBBA",
        "first_name": "BRIJESH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AZ",
            "license": "35785",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "35785",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159825",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00366089",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.