Individual provider Active NPI

Anthony Bonanno, M.D.

  • Anesthesiology Physician
  • Smithtown, NY
National Provider Identifier
1174615751
Registry record updated Jan 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
167355 Issued in NY
Practice address
50 Route 25a
Smithtown, NY 11787
Phone
(631) 862-3413
Fax
(631) 862-3604
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 167355 NY Primary
Critical Care Medicine (Anesthesiology) Physician 207LC0200X 167355-1 NY

Addresses

Primary practice location

50 Route 25a
Smithtown, NY 11787

Mailing address

50 Route 25a
Employee Services Building
Smithtown, NY 11787
Phone (631) 862-3413

Other identifiers 1

IdentifierTypeStateIssuer
01067216MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20150127001511 FL Practitioner - Anesthesiology 0143295972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
New York Medical College, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
US Anesthesia Partners of Florida IncGroup PAC ID 0345143152, 1,111 clinicians

Practice addresses (Care Compare)

1000 Waterman Way
Tavares, FL 32778-5266
Phone (352) 253-3333

1800 N Hancock Rd
Minneola, FL 34715-8184
Phone (689) 289-2000

2000 Fowler Grove Blvd
Winter Garden, FL 34787-5050
Phone (407) 614-0500

2450 N Orange Blossom Trail
Kissimmee, FL 34744-2316
Phone (407) 846-4343

410 Celebration PL
Suite 408
Celebration, FL 34747-5436
Phone (407) 650-0051

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-5600

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
  • Adventhealth Waterman Hospital, Tavares, FL, CCN 100057

Merit-based Incentive Payment System (MIPS)

Final score
94.8 of 100Reported as group
Quality
99.47
Improvement activities
40
Cost
83.62

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
167355NYMDAnesthesiology Physician
167355-1NYMDCritical Care Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
US Anesthesia Partners of Florida Inc. Anesthesiology CurrentSince Jan 5, 2015 Accepting new patients
Alliance Anesthesiology Associates, P.L.L.C. Anesthesiology Past Accepting new patients
Office Based Anesthesia LLC Anesthesiology Past Accepting new patients
United Anesthesia PC Anesthesiology Past Accepting new patients

Locations

291 Southhall Ln
Ste 201
Maitland, FL 32751
Phone 40766704444

851 Trafalgar Ct
Ste 200E
Maitland, FL 32751
Phone (321) 422-7155

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296172800000",
    "number": "1174615751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 ROUTE 25A",
            "address_2": "EMPLOYEE SERVICES BUILDING",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "11787",
            "telephone_number": "631-862-3413",
            "fax_number": "631-862-3604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 ROUTE 25A",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "11787",
            "telephone_number": "631-862-3413",
            "fax_number": "631-862-3604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONANNO",
        "first_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2011-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "167355",
            "primary": true
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "NY",
            "license": "167355-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01067216",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.