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JACQUELINE GRACE BOBER D.O.
NPI 1982916870
Student in an Organized Health Care Education/Training Program in West Islip, NY

Active since July 08, 2010PECOS Enrolled
1000 MONTAUK HWY, WEST ISLIP, NY 11795(631) 376-4444 Get Directions Write a Review

NPPES record last updated: July 20, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jacqueline Grace Bober D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACQUELINE GRACE BOBER D.O. (NPI 1982916870) is an individual student in an organized health care education/training program in West Islip, New York and active in the NPI registry since July 2010. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1982916870
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameJACQUELINE GRACE BOBERCredential: D.O.
Location Address1000 MONTAUK HWYWest Islip, NY 11795-4927
Mailing Address1000 Montauk HwyWest Islip, NY 11795-4927 · (631) 376-4444
Phone(631) 376-4444
Sole ProprietorNo
Enumeration DateJuly 8, 2010
Last NPPES UpdateJuly 20, 2012
✔ NPI 1982916870 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1000 MONTAUK HWY, West Islip, NY 11795
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacqueline Grace Bober D.o. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ANTHONY NGUYEN MD
Obstetrics & Gynecology
1000 MONTAUK HWY
WEST ISLIP, NY 11795
Suffolk County (631) 376-4163
LAUREN MARIE CHOBAN DO
Emergency Medicine
1000 MONTAUK HWY
WEST ISLIP, NY 11795
Suffolk County (631) 376-3000
MISS MUNMUN AZIZ MD
Student in an Organized Health Care Education/Training Program
1000 MONTAUK HWY
WEST ISLIP, NY 11795
Suffolk County (929) 340-5665
TERENCE JAMES OMALLEY MD
Anesthesiology
1000 MONTAUK HWY, GOOD SAMARITAN HOSPITAL MEDICAL CENTER
WEST ISLIP, NY 11795
Suffolk County (631) 376-4088
PIOTR PAPUZINSKI MD
Internal Medicine
1000 MONTAUK HWY
WEST ISLIP, NY 11795
Suffolk County (631) 376-3000
LAURIE WATERS PA
Physician Assistant
1000 MONTAUK HWY
WEST ISLIP, NY 11795
Suffolk County (631) 376-3000
SHELLEY MATSON RN
Registered Nurse
1000 MONTAUK HWY
WEST ISLIP, NY 11795
Suffolk County (631) 376-3000
RIDDA MANZOOR MD
Student in an Organized Health Care Education/Training Program
1000 MONTAUK HWY
WEST ISLIP, NY 11795
Suffolk County (631) 376-4163

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacqueline Bober's NPI number?

The NPI number for Jacqueline Bober is 1982916870. It was assigned to this individual provider in the NPPES registry on July 8, 2010.

Where is Jacqueline Bober located?

Jacqueline Bober practices at 1000 Montauk Hwy, West Islip, NY 11795. The listed phone number is (631) 376-4444.

What is Jacqueline Bober's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jacqueline Bober enrolled in Medicare?

Yes. Jacqueline Bober is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jacqueline Bober was last updated on July 20, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.