Nicole Theresa Buonanno, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

010169-1 Issued in NY

Practice address

9 Livingston Street
Suite 5 - Dr. Kucherov
Poughkeepsie, NY 12601

Phone

(845) 454-0728

Fax

(845) 454-0914

NPI assigned

Jan 2, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

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

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ecu Health Medical Center Hospital, Greenville, NC, CCN 340040
• Ecu Health Bertie Hospital Hospital, Windsor, NC, CCN 341304

Merit-based Incentive Payment System (MIPS)

Final score

96.95 of 100Reported as apm

Quality

82.44

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Vidant Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Greenville, NC
  • NPI 1477648731
  Medicare reassignment Care Compare group NPD

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

• East Carolina Health-Bertie

  dba ECU Health Bertie Hospital

  • Critical Access Hospital
  • Windsor, NC
  • NPI 1013999705
  Care Compare affiliation
• Pitt County Memorial Hospital Inc

  dba ECU Health Beaufort Hospital-a campus of ECU Health Medical Center

  • General Acute Care Hospital
  • Washington, NC
  • NPI 1780359687
  Care Compare affiliation
• Pitt County Memorial Hospital, Inc

  dba ECU Health Medical Center

  • General Acute Care Hospital
  • Greenville, NC
  • NPI 1043218944
  Care Compare affiliation

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104983212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4023 THOMAS PAINE WAY",
            "city": "NEW WINDSOR",
            "state": "NY",
            "postal_code": "12553",
            "telephone_number": "845-821-3818",
            "fax_number": "845-454-0914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 LIVINGSTON STREET",
            "address_2": "SUITE 5 - DR. KUCHEROV",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "12601",
            "telephone_number": "845-454-0728",
            "fax_number": "845-454-0914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUONANNO",
        "first_name": "NICOLE",
        "middle_name": "THERESA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "010169-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Duyet Bui, MD
• Thuc Ha Minh Bui, PA
• Cheryl Bullen, LPN
• Margrit T Bunk
• Kelly Bunt Bishop, LCSW
• Adrienne Monique Buonato
• Thomas G Buono, CDN
• Rachel Burday, PA-C
• Vicky Marie Burgh-Harris, LCSW
• Leanna Burgos, LPN

• Medical Physician Assistant in Poughkeepsie, NY
• Providers in Poughkeepsie, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.