JACQUELINE GRACE BOBER D.O.
NPI 1982916870
Student in an Organized Health Care Education/Training Program in West Islip, NY
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
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jacqueline Grace Bober D.o. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Jacqueline Bober reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
West Islip, NY 11795
- Reassigned Medicare billing, New York enrollment
- 91 clinicians in this Medicare group
Stony Brook, NY 11794
- Reassigned Medicare billing, New York enrollment
- 191 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
WEST ISLIP, NY 11795
WEST ISLIP, NY 11795
WEST ISLIP, NY 11795
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.
Which organizations bill Medicare for Jacqueline Bober's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jacqueline Bober reassigns Medicare benefits to 2 organizations: Samaritan Emergency Medical Services, PC (West Islip, NY) and Stony Brook Children's Service, University Faculty Practice Corporatio (Stony Brook, NY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jacqueline Bober's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
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.
# Jacqueline Grace Bober, D.O. · NPI 1982916870
Student in an Organized Health Care Education/Training Program provider in West Islip, New York. Individual provider, active in the CMS NPPES registry since July 8, 2010.
## Identity
- **NPI:** 1982916870 (Entity type: Individual)
- **Enumerated:** July 8, 2010
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 1000 MONTAUK HWY, West Islip, NY 11795-4927
- **Phone:** (631) 376-4444
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Samaritan Emergency Medical Services, PC (NPI 1104978014, West Islip, NY); Stony Brook Children's Service, University Faculty Practice Corporatio (NPI 1083660575, Stony Brook, NY) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 20, 2012
---
Source: [NPI Profile](https://npiprofile.com/npi/1982916870) · Data from the CMS NPPES public registry.