Bartholomew J Bonazinga, M.D., F.A.C.C.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

042-0006395 Issued in VT

Practice address

12 Commons St
Rutland, VT 05701

Phone

(802) 747-3600

Fax

(802) 773-8501

NPI assigned

Nov 22, 2006

Last updated

Jan 16, 2019By 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 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Integrative Cardiology

  • Specialist
  • Rutland, VT
  • NPI 1083803795
  NPD (past) Authorized official
• Rutland Regional Health Services

  dba Rutland Cardiovascular Associates

  • Cardiovascular Disease Physician
  • Rutland, VT
  • NPI 1679868749
  NPD (past)

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1013082098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 COMMONS ST",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014651",
            "telephone_number": "802-747-3600",
            "fax_number": "802-773-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 COMMONS ST",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "05701",
            "telephone_number": "802-747-3600",
            "fax_number": "802-773-8501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Commons St",
            "address_purpose": "LOCATION",
            "city": "Rutland",
            "state": "VT",
            "postal_code": "057014652",
            "country_code": "US",
            "telephone_number": "802-775-0100",
            "fax_number": "802-775-4135",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "160 Allen St",
            "address_purpose": "LOCATION",
            "city": "Rutland",
            "state": "VT",
            "postal_code": "057014560",
            "country_code": "US",
            "telephone_number": "802-775-7111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONAZINGA",
        "first_name": "BARTHOLOMEW",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "M.D., F.A.C.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VT",
            "license": "042-0006395",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VT",
            "license": "042-0006395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009657",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "926404",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00005223",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "INTE00048942",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Bloomfield, L. AC
• Jacquelyn Ellen Bode, M.ED.
• William James Bogertman, RN
• Chynah Boise, LCMHC
• Erica Bolster, RN
• Boston Psychotherapy, PLC
• Deborah E. Boston, LICSW
• Marcie Bouchard, M.S.ED., C.A.S.
• Ernest M Bove, MD
• Janel Elaina Bove, BSW

• Cardiovascular Disease Physician in Rutland, VT
• Providers in Rutland, VT by specialty
• Cardiovascular Disease Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.