Mark Dewald Bobbin, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

253912 Issued in MA

Practice address

110 Liberty St
Brockton, MA 02301-5674

Phone

(508) 565-3275

NPI assigned

Oct 16, 2012

Last updated

Nov 13, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

Diagnostic Radiology

Education

Rutgers New Jersey Medical School, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Signature Healthcare Medical Group IncGroup PAC ID 7719876267, 250 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Signature Healthcare Brockton Hospital Hospital, Brockton, MA, CCN 220052

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Signature Healthcare Medical Group Inc

  dba Signature Medical

  • Internal Medicine Physician
  • Brockton, MA
  • NPI 1508804949
  Medicare reassignment Care Compare group NPD
• Steward Medical Group, Inc

  • Specialist
  • Brighton, MA
  • NPI 1356654495
  Medicare reassignment NPD
• Steward Medical Group, Inc

  • Internal Medicine Physician
  • Dartmouth, MA
  • NPI 1821349317
  Medicare reassignment NPD
• Brigham & Womens Physicians Organization Inc

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1033535497
  Medicare reassignment
• Shields Signature Imaging, LLC

  • Mobile Radiology Clinic/Center
  • Brockton, MA
  • NPI 1417320912
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Brockton Hospital, Inc.

  dba Signature Healthcare Brockton Hospital

  • General Acute Care Hospital
  • Brockton, MA
  • NPI 1063431286
  Care Compare affiliation

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

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1639422637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 LIBERTY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015674",
            "telephone_number": "508-565-3275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LIBERTY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015674",
            "telephone_number": "508-565-3275"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Madison Avenue",
            "address_2": "MMC - Department of Radiology",
            "address_purpose": "LOCATION",
            "city": "Morristown",
            "state": "NJ",
            "postal_code": "07960",
            "country_code": "US",
            "telephone_number": "973-971-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOBBIN",
        "first_name": "MARK",
        "middle_name": "DEWALD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-16",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "253912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sebastian James Bliss, PHD
• Sarah Beth Blodgett, LCSW 225289
• Brooke J Bloom, M.D.
• Dana Paul Boardman, KINESIOTHERAPIST
• Rebekah Michelle Boateng
• Srinivas Bodapati, MD
• Lynne D Boddie
• Body Healing Therapeutic Inc
• Daniel John Boen
• Carolyn B Bogal, NP

• Diagnostic Radiology Physician in Brockton, MA
• Providers in Brockton, MA by specialty
• Diagnostic Radiology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.