Active NPI
Wilbur C Bobila, MD
- Surgery Physician
- Hainesport, NJ
National Provider Identifier
1386745289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 25MA04356200
- Practice address
- 212 Creek Crossing Blvd
Hainesport, NJ 08036-2766 - Phone
- (609) 267-1004
- Fax
- (609) 267-1044
- NPI assigned
- Sep 26, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 25MA04356200 | NJ | Primary |
Addresses
Primary practice location
212 Creek Crossing Blvd
Hainesport, NJ 08036-2766
Mailing address
40 Lake Center 401 Route 73 North
Suite 201a
Marlton, NJ 08053-3425
Phone (856) 355-0340
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0415405 | Medicaid | NJ |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA04356200 | NJ | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Virtua Surgical Group, P.a | Surgery | Past | Accepting new patients |
| Medford Surgical Practice | Surgery | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Surgery Physician
- Cherry Hill, NJ
- NPI 1184811945
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336003200000",
"number": "1386745289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 LAKE CENTER 401 ROUTE 73 NORTH",
"address_2": "SUITE 201A",
"city": "MARLTON",
"state": "NJ",
"postal_code": "080533425",
"telephone_number": "856-355-0340",
"fax_number": "856-355-0346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "212 CREEK CROSSING BLVD",
"city": "HAINESPORT",
"state": "NJ",
"postal_code": "080362766",
"telephone_number": "609-267-1004",
"fax_number": "609-267-1044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOBILA",
"first_name": "WILBUR",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-26",
"last_updated": "2012-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NJ",
"license": "25MA04356200",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0415405",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hainesport, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.