Active NPI
Bonnie Degroff
- Registered Nurse
- Newburgh, NY
National Provider Identifier
1184881534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 297025-1
- Practice address
- 1702 Barclay MNR
Newburgh, NY 12550-7803 - Phone
- (845) 484-4557
- NPI assigned
- May 21, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 297025-1 | NY | Primary |
Addresses
Primary practice location
1702 Barclay MNR
Newburgh, NY 12550-7803
Mailing address
1702 Barclay MNR
Newburgh, NY 12550-7803
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01641143 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 297025-1 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211846400000",
"number": "1184881534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1702 BARCLAY MNR",
"city": "NEWBURGH",
"state": "NY",
"postal_code": "125507803"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1702 BARCLAY MNR",
"city": "NEWBURGH",
"state": "NY",
"postal_code": "125507803",
"telephone_number": "845-484-4557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEGROFF",
"first_name": "BONNIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-21",
"last_updated": "2008-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "297025-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01641143",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newburgh, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.