Individual provider Active NPI

Amy Bonomo, AUD

  • Audiologist
  • Boulder, CO
National Provider Identifier
1073402574
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
1348 Issued in CO
Practice address
4745 Arapahoe Ave Ste 130
Boulder, CO 80303-1082
Phone
(303) 443-2771
NPI assigned
Jun 30, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 1348 CO Primary

Addresses

Primary practice location

4745 Arapahoe Ave Ste 130
Boulder, CO 80303-1082

Mailing address

3736 Mariposa St
Denver, CO 80211-2648
Phone (570) 582-4063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250807002785 CO Practitioner - Qualified Audiologist 0244738466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boulder Valley Ear Nose and Throat Associates PCGroup PAC ID 9234128216, 15 clinicians

Practice addresses (Care Compare)

4745 Arapahoe Ave
Suite 130
Boulder, CO 80303-1082
Phone (303) 443-2771

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1348COMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Valley Ear Nose & Throat Associates PC CurrentSince Jun 30, 2025 Accepting new patients

Locations

4745 Arapahoe Ave
Ste 130
Boulder, CO 80303
Phone (303) 443-2771

90 Health Park Dr
Ste 220
Louisville, CO 80027
Phone (303) 443-2771

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1751241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1073402574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3736 MARIPOSA ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802112648",
            "telephone_number": "570-582-4063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 ARAPAHOE AVE STE 130",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031082",
            "telephone_number": "303-443-2771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONOMO",
        "first_name": "AMY",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-30",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CO",
            "license": "1348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.