NPIMap

Individual provider Active NPI

Valerie Bonica, DO

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1184885329
Registry record updated Sep 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OT012330 Issued in PA
Practice address
500 S Broad St
3Rd Floor
Philadelphia, PA 19146-1613
Phone
(215) 685-6790
Fax
(215) 685-6732
NPI assigned
Jun 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OT012330 PA Primary

Addresses

Primary practice location

500 S Broad St
3Rd Floor
Philadelphia, PA 19146-1613

Mailing address

321 W Girard Ave
Philadelphia, PA 19123-1531
Phone (215) 685-3803

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111230000486 PA Practitioner - Family Practice 9638345366 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City of PhiladelphiaGroup PAC ID 6305758723, 86 clinicians

Practice addresses (Care Compare)

321 W Girard Ave
Health Care Ctr 6
Philadelphia, PA 19123-1531
Phone (215) 685-3808

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OT012330PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
City of Philadelphia CurrentSince Nov 12, 2011 Accepting new patients
City of Philadelphia CurrentSince Nov 12, 2011 Accepting new patients
City of Philadelphia Current Accepting new patients
City of Philadelphia Past Accepting new patients

Locations

4400 Haverford Ave
#4
Philadelphia, PA 19104
Phone (215) 685-7600

500 S Broad St
Fl 3
Philadelphia, PA 19146
Phone (215) 685-6790

321 W Girard Ave
Philadelphia, PA 19123
Phone (215) 685-3803

1101 Market St
Fl 10
Philadelphia, PA 19107

Interoperability endpoints

  • Direct secure messaging: valerie.bonica@pdphahs.eclinicaldirectplus.com

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315440000000",
    "number": "1184885329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 W GIRARD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191231531",
            "telephone_number": "215-685-3803",
            "fax_number": "215-685-3816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S BROAD ST",
            "address_2": "3RD FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191461613",
            "telephone_number": "215-685-6790",
            "fax_number": "215-685-6732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONICA",
        "first_name": "VALERIE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-20",
        "last_updated": "2011-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OT012330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.