Individual provider Active NPI

Joseph M Bobovsky, MD

  • Anesthesiology Physician
  • Yakima, WA
National Provider Identifier
1477562072
Registry record updated Dec 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD00022582 Issued in WA
Practice address
406 S 30TH Ave
Ste 202
Yakima, WA 98902-3713
Phone
(509) 972-1051
Fax
(509) 972-4166
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD00022582 WA Primary

Addresses

Primary practice location

406 S 30TH Ave
Ste 202
Yakima, WA 98902-3713

Mailing address

406 S 30TH Ave
Ste 202
Yakima, WA 98902-3713
Phone (509) 972-1051

Other identifiers 2

IdentifierTypeStateIssuer
1007475MedicaidWA
050038560OtherWARAILROAD MEDICARE

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

LicenseStateTypeSpecialty
MD00022582WAMDAnesthesiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197849600000",
    "number": "1477562072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 S 30TH AVE",
            "address_2": "STE 202",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023713",
            "telephone_number": "509-972-1051",
            "fax_number": "509-972-4166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 S 30TH AVE",
            "address_2": "STE 202",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023713",
            "telephone_number": "509-972-1051",
            "fax_number": "509-972-4166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBOVSKY",
        "first_name": "JOSEPH",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD00022582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007475",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "050038560",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.