Mitchell Bober, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MB044548 Issued in NJ

Practice address

181 N Broadway
Pennsville, NJ 08070-1550

Phone

(856) 678-9002

Fax

(856) 678-4027

NPI assigned

Jul 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Mitchell Bober, D.O.

  • Family Medicine Physician
  • Pennsville, NJ
  • NPI 1154366466
  NPD (past) Authorized official

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1902805013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 N BROADWAY",
            "city": "PENNSVILLE",
            "state": "NJ",
            "postal_code": "080701550",
            "telephone_number": "856-678-9002",
            "fax_number": "856-678-4027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 N BROADWAY",
            "city": "PENNSVILLE",
            "state": "NJ",
            "postal_code": "080701550",
            "telephone_number": "856-678-9002",
            "fax_number": "856-678-4027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBER",
        "first_name": "MITCHELL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MB044548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1218905",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00712354",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allies, Inc.
• Assisted Living Concepts Inc
• Bancroft a New Jersey Nonprofit Corporation
• Bar Physical Therapy
• Michael Lawrence Blackhurst, DDS
• Christopher Joseph Boston, O.D.
• Braden Dental of South Jersey PC
• Ronald L Brittner, DPM
• Octavius L Brown, MSCC, LPC, LCADC
• Stacey Camac, LAC

• Family Medicine Physician in Pennsville, NJ
• Providers in Pennsville, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.