NPIMap

Individual provider Active NPI

Steven Bonebrake, D.O.

  • Vascular & Interventional Radiology Physician
  • Danville, PA
National Provider Identifier
1013150887
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
OS015786 Issued in PA
Practice address
100 N Academy Ave
Danville, PA 17822-9800
Phone
(570) 271-5555
Fax
(570) 271-5269
NPI assigned
Apr 9, 2009
Last updated
Nov 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X OS015786 PA
Diagnostic Radiology Physician 2085R0202X OS015786 PA
Vascular & Interventional Radiology Physician 2085R0204X OS015786 PA Primary
Hospitalist Physician 208M00000X OS015786 PA

Addresses

Primary practice location

100 N Academy Ave
Danville, PA 17822-9800

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sbonebrake85594@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111121000870 PA Practitioner - Interventional RadiologyPractitioner - Internal Medicine 7517131907 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
Philadelphia College of Osteopathic Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guthrie Medical Group PCGroup PAC ID 6002728656, 795 clinicians
Dubois Regional Medical CenterGroup PAC ID 5890689715, 424 clinicians

Practice addresses (Care Compare)

1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858

187 Hospital Dr
Tyrone, PA 16686-1808
Phone (814) 684-1255

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Dubois Regional Medical Center Diagnostic Radiology CurrentSince Feb 7, 2022 Accepting new patients
Guthrie Medical Group, P.C. Diagnostic Radiology CurrentSince Feb 1, 2022 Accepting new patients
Guthrie Medical Group, P.C. Internal Medicine CurrentSince Feb 1, 2022 Accepting new patients
Dubois Regional Medical Center CurrentSince Feb 7, 2022 Accepting new patients
Guthrie Medical Group, P.C. Current Accepting new patients

Locations

100 Hospital Ave
Dubois, PA 15801
Phone (814) 375-2040

763 Johnsonburg Rd
Saint Marys, PA 15857
Phone (814) 788-8000

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

187 Hospital Dr
Tyrone, PA 16686
Phone (814) 342-2333

Interoperability endpoints

  • Direct secure messaging: sbonebrake85594@direct.geisinger.edu

Organizations & group practices 5

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.

Hospital & facility affiliations 46

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1239235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1013150887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178229800",
            "telephone_number": "570-271-5555",
            "fax_number": "570-271-5269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONEBRAKE",
        "first_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-09",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS015786",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "OS015786",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "PA",
            "license": "OS015786",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "OS015786",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sbonebrake85594@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "100 N Academy Ave",
            "city": "Danville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "178229800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.