Individual provider Active NPI

Kathleen Buonomo, CRNA

  • Certified Registered Nurse Anesthetist
  • Havertown, PA
National Provider Identifier
1215925862
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN246195L Issued in PA
Practice address
2010 Old West Chester Pike
Suite 330
Havertown, PA 19083-2712
Phone
(610) 789-8070
Fax
(610) 789-9937
NPI assigned
Oct 7, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN246195L PA Primary

Addresses

Primary practice location

2010 Old West Chester Pike
Suite 330
Havertown, PA 19083-2712

Mailing address

333 N Oxford Valley Rd
Ste 510
Fairless Hills, PA 19030-2629
Phone (215) 785-0145

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)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN246195LPAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Mid-Atlantic Anesthesia Associates PC Nurse Anesthetist, Certified Registered PastSince Sep 15, 2019 Accepting new patients
Clinical Pain Management Associates, PC Past Accepting new patients
Main Line Gastroenterology Associates, PC Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1215925862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N OXFORD VALLEY RD",
            "address_2": "STE 510",
            "city": "FAIRLESS HILLS",
            "state": "PA",
            "postal_code": "190302629",
            "telephone_number": "215-785-0145",
            "fax_number": "215-785-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 OLD WEST CHESTER PIKE",
            "address_2": "SUITE 330",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190832712",
            "telephone_number": "610-789-8070",
            "fax_number": "610-789-9937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUONOMO",
        "first_name": "KATHLEEN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-07",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN246195L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Havertown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.