Individual provider Active NPI

Joseph Bonomolo III, M.D.

  • Anesthesiology Physician
  • Tucson, AZ
National Provider Identifier
1154566651
Registry record updated Oct 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
42961 Issued in AZ
Practice address
3390 N Campbell Ave Ste 110
Tucson, AZ 85719-2380
Phone
(520) 795-7650
NPI assigned
Dec 11, 2008
Last updated
Oct 25, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 42961 AZ Primary

Addresses

Primary practice location

3390 N Campbell Ave Ste 110
Tucson, AZ 85719-2380

Mailing address

3390 N. Campbell Ave. #110
Tucson, AZ 85719-2390
Phone (520) 795-7650

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20101027001539 AZ Practitioner - Anesthesiology 1759575384 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
George Washington University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Arizona Anesthesia Services PCGroup PAC ID 1850382565, 44 clinicians
Northeastern Anesthesia PLLCGroup PAC ID 4284813940, 83 clinicians
Hospitalist Medicine Physicians of Arizona - NogalesGroup PAC ID 9335554625, 11 clinicians

Practice addresses (Care Compare)

3390 N Campbell Ave
Suite 110
Tucson, AZ 85719-2380
Phone (520) 795-7650

5700 E Hwy 90
Sierra Vista, AZ 85635-9110
Phone (520) 263-3835

5755 S Houghton Rd
Tucson, AZ 85747-0002
Phone (520) 324-5818

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Arizona - Nogales Anesthesiology CurrentSince May 12, 2024 Accepting new patients
Northeastern Anesthesia PLLC Anesthesiology CurrentSince Jul 1, 2025 Accepting new patients
Valley Regional Anesthesia Associates Inc Anesthesiology CurrentSince Feb 24, 2025 Accepting new patients
Ias Arizona PLLC Anesthesiology CurrentSince Sep 20, 2023 Accepting new patients
Southern Arizona Anesthesia Services, PC Anesthesiology CurrentSince Jul 26, 2010 Accepting new patients

Locations

5330 S Highway 95
Fort Mohave, AZ 86426
Phone (928) 788-2273

2200 E Show Low Lake Rd
Show Low, AZ 85901
Phone (928) 537-4375

5700 E Highway 90
Sierra Vista, AZ 85635
Phone (520) 263-2000

10360 E Drexel Rd
Tucson, AZ 85747
Phone (469) 340-1366

1601 W Saint Marys Rd
Tucson, AZ 85745
Phone (520) 622-5833

3390 N Campbell Ave
Ste 110
Tucson, AZ 85719
Phone (520) 784-2243

350 N Wilmot Rd
Tucson, AZ 85711
Phone (520) 873-3000

5755 S Houghton Rd
Tucson, AZ 85747
Phone (520) 324-1727

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 5

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

NPI Registry JSON

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

{
    "created_epoch": "1228953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287964800000",
    "number": "1154566651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3390 N. CAMPBELL AVE. #110",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857192390",
            "telephone_number": "520-795-7650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3390 N CAMPBELL AVE STE 110",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857192380",
            "telephone_number": "520-795-7650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONOMOLO",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-11",
        "last_updated": "2010-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "42961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.