Jacqueline Grace Bober, D.O.

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1000 Montauk Hwy
West Islip, NY 11795-4927

Phone

(631) 376-4444

NPI assigned

Jul 8, 2010

Sex

Female

Sole proprietor

No

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 NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678

Interoperability endpoints

• Direct secure messaging: jacqueline.bober@direct.stonybrookmedicine.edu

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.

• Samaritan Emergency Medical Services, PC

  • Emergency Medicine Physician
  • West Islip, NY
  • NPI 1104978014
  Medicare reassignment NPD
• Stony Brook Children'S Service, University Faculty Practice Corporatio

  • Pediatrics Physician
  • Stony Brook, NY
  • NPI 1083660575
  Medicare reassignment NPD
• University Hospital at Stony Brook

  • General Acute Care Hospital
  • Stony Brook, NY
  • NPI 1972523348
  NPD

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

{
    "created_epoch": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342742400000",
    "number": "1982916870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MONTAUK HWY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954927",
            "telephone_number": "631-376-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MONTAUK HWY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954927",
            "telephone_number": "631-376-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBER",
        "first_name": "JACQUELINE",
        "middle_name": "GRACE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-08",
        "last_updated": "2012-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly A Bivona, LPN
• Taylor Blanket, LMSW
• Steven A Blau, MD
• Blossoms of Change Counseling LCSW PLLC
• Kristen Marie Blydenburgh, RPA-C
• Wojciech Bober, D.O.
• Jill Anne Bocchieri
• Rao Bodapati, MD
• Nicole Boeckel, FNP
• Mary Elizabeth Bonafede, M.D.

• Student in an Organized Health Care Education/Training Program in West Islip, NY
• Providers in West Islip, NY by specialty
• Student in an Organized Health Care Education/Training Program in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2012; 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.