Individual provider Active NPI

Aaron Justin Bobb, MD

  • Psychiatry Physician
  • Renton, WA
National Provider Identifier
1407185382
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD60549266 Issued in WA
Practice address
4445 Talbot Rd S
Renton, WA 98055-6219
Phone
(425) 690-3414
Fax
(425) 690-9414
NPI assigned
Dec 23, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD60549266 WA Primary

Addresses

Primary practice location

4445 Talbot Rd S
Renton, WA 98055-6219

Mailing address

3600 Lind Ave SW
Suite 100 Attn Credentialing
Renton, WA 98057-4970
Phone (425) 690-2715

Other identifiers 1

IdentifierTypeStateIssuer
2046409MedicaidWA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address abobb55555@direct.valleymed.org Direct
FHIR URL https://FHIR.valleymed.org/FHIR-PRD/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20150901002224 WA Practitioner - Psychiatry 0648438218 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Johns Hopkins University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Medical Group-RentonGroup PAC ID 4183753965, 419 clinicians

Practice addresses (Care Compare)

4445 Talbot Rd S
Renton, WA 98055-6219
Phone (425) 656-4055

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Medical Group-Renton Psychiatry CurrentSince Jul 1, 2015 Accepting new patients

Locations

16850 SE 272nd St
Ste 100
Covington, WA 98042
Phone (253) 395-1971

4445 Talbot Rd S
Renton, WA 98055
Phone (425) 656-4055

3600 Lind Ave SW
Ste 100
Renton, WA 98057

Interoperability endpoints

  • Direct secure messaging: abobb55555@direct.valleymed.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1261526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1407185382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 LIND AVE SW",
            "address_2": "SUITE 100 ATTN CREDENTIALING",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980574970",
            "telephone_number": "425-690-2715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 TALBOT RD S",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980556219",
            "telephone_number": "425-690-3414",
            "fax_number": "425-690-9414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBB",
        "first_name": "AARON",
        "middle_name": "JUSTIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-23",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD60549266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2046409",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abobb55555@direct.valleymed.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "abobb55555@direct.valleymed.org",
            "address_1": "4445 Talbot Rd S",
            "city": "Renton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980556219",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://FHIR.valleymed.org/FHIR-PRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "4445 Talbot Rd S",
            "city": "Renton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980556219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.