Gary Bonfante, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

OS008555L Issued in PA

Practice address

1000 E Mountain Blvd
Wilkes Barre, PA 18711-0027

Phone

(570) 808-7762

Fax

(570) 808-6128

NPI assigned

Jun 20, 2006

Last updated

Aug 12, 2019By the provider in NPPES

Sex

Male

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 PA

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

Specialty

Emergency Medicine

Education

Philadelphia College of Osteopathic Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gslpg, IncGroup PAC ID 7810226875, 269 clinicians

Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Geisinger St. Luke's Hospital Hospital, Orwigsburg, PA, CCN 390332

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gbonfante189789@direct.geisinger.edu

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.

• Geisinger Clinic

  • Family Medicine Physician
  • Danville, PA
  • NPI 1366493868
  Medicare reassignment Care Compare group NPD
• Gslpg, Inc

  • Specialist
  • Orwigsburg, PA
  • NPI 1366006702
  Medicare reassignment Care Compare group NPD
• Lehigh Valley Physician Group

  dba LVPG Developmental Pediatrics

  • Developmental - Behavioral Pediatrics Physician
  • Allentown, PA
  • NPI 1780155689
  Medicare reassignment
• St. Luke's Physician Group, Inc.

  dba South Mountain Family Practice

  • Family Medicine Physician
  • Bethlehem, PA
  • NPI 1700984622
  Medicare reassignment
• Geisinger Clinic

  • Diagnostic Radiology Physician
  • Danville, PA
  • NPI 1558313023
  NPD
• Geisinger Clinic

  • Addiction (Substance Use Disorder) Psychologist
  • Scranton, PA
  • NPI 1639600075
  NPD
• Lehigh Valley Physician Group

  dba LVPG Family and Internal Medicine - East Stroudsburg

  • Family Medicine Physician
  • East Stroudsburg, PA
  • NPI 1245093368
  NPD
• Lehigh Valley Physician Group

  dba LVPG Internal Medicine - East Stroudsburg

  • Internal Medicine Physician
  • East Stroudsburg, PA
  • NPI 1285499137
  NPD
• Lehigh Valley Physician Group

  • Transplant Surgery Physician
  • Allentown, PA
  • NPI 1457309650

  Emergency Medicine

  NPD
• St Luke's Physician Group Inc

  dba St. Luke's Primary Care Orwigsburg

  • Family Medicine Physician
  • Orwigsburg, PA
  • NPI 1710845144
  NPD
• St. Luke's Physician Group, Inc.

  • Anatomic Pathology & Clinical Pathology Physician
  • Bethlehem, PA
  • NPI 1164860391
  NPD

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

• GSL Hospital

  • General Acute Care Hospital
  • Orwigsburg, PA
  • NPI 1265096069
  Care Compare affiliation

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1063457182",
    "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": "1000 E MOUNTAIN BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187110027",
            "telephone_number": "570-808-7762",
            "fax_number": "570-808-6128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONFANTE",
        "first_name": "GARY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS008555L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kala Bokeko, PA-C
• Brian Eric Bolden, MD
• Kelly M Bolesta, PHARM.D.
• Joseph John Bolinsky III, PA-C
• Kavita S Bommasamudram, MD
• Joann Bonn, PHARMD
• Steven Anthony Bonomo, D.D.S.
• Rebecca Marie Boran, PTA
• Jacob Patrick Borkowski
• Jennifer Marie Borowski, PHARMD

• Emergency Medicine Physician in Wilkes Barre, PA
• Providers in Wilkes Barre, PA by specialty
• Emergency Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.