John Bivona Jr., M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

103645-1 Issued in NY

Practice address

21 Laurel Ave
Suite 210
Cornwall, NY 12518-1481

Phone

(845) 534-0008

Fax

(845) 534-0018

NPI assigned

Sep 27, 2006

Sex

Male

Sole proprietor

Yes

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

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 and National Provider Directory roles.

• Advanced Surgical Care, PC

  • Specialist
  • Cornwall, NY
  • NPI 1255524898
  NPD (past)

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207872000000",
    "number": "1093806580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 LAUREL AVE",
            "address_2": "STE 210",
            "city": "CORNWALL",
            "state": "NY",
            "postal_code": "125181481",
            "telephone_number": "845-534-0008",
            "fax_number": "845-534-0018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 LAUREL AVE",
            "address_2": "SUITE 210",
            "city": "CORNWALL",
            "state": "NY",
            "postal_code": "125181481",
            "telephone_number": "845-534-0008",
            "fax_number": "845-534-0018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIVONA",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2008-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "103645-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas George Bambino, MD
• Tracey Anne Barnes, LCSW
• Aviva Tova Bashkowitz, LCSW
• Sara E Bayne, BSN, RN
• Gail Gold Berger, BCBA
• Bodhi Tree Mental Health Counseling
• Maheswar Reddy Budili
• Romilda Canale
• Roseli Caponero, OTR/L
• Lisa Marie Cardona, LMHC

• Surgery Physician in Cornwall, NY
• Providers in Cornwall, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2008; 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.