Individual provider Active NPI

Bonnie L. Rosenfeld, P.A.-C.

  • Surgical Physician Assistant
  • Vancouver, WA
National Provider Identifier
1225074990
Registry record updated Oct 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA10004003 Issued in WA
Practice address
200 NE Mother Joseph PL
Suite 110
Vancouver, WA 98664-3299
Phone
(360) 254-6161
Fax
(360) 449-1146
NPI assigned
Jun 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA10004003 WA Primary

Addresses

Primary practice location

200 NE Mother Joseph PL
Suite 110
Vancouver, WA 98664-3299

Mailing address

200 NE Mother Joseph PL
Suite 210
Vancouver, WA 98664-3299
Phone (360) 254-6161

Other identifiers 1

IdentifierTypeStateIssuer
8355166MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050315000906 WA Practitioner - Physician Assistant 7719932490 Reassigns benefits to 1 organization
I20050422000179 OR Practitioner - Physician Assistant 7719932490 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Surgical Specialists PC CurrentSince Jun 26, 2000 Accepting new patients
Northwest Surgical Specialists, P.C. CurrentSince Jun 26, 2000 Accepting new patients
J and D Physical Therapy Services Past Accepting new patients

Locations

1 N Center Court St
Ste 11
Portland, OR 97227
Phone (503) 732-6863

200 NE Mother Joseph Pl
Ste 110
Vancouver, WA 98664
Phone (360) 256-8584

200 NE Mother Joseph Pl
Ste 210
Vancouver, WA 98664
Phone (360) 449-1145

200 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2990

400 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2000

Interoperability endpoints

  • Direct secure messaging: bonnie.rosenfeldpac.p1@direct.reboundmd.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191974400000",
    "number": "1225074990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NE MOTHER JOSEPH PL",
            "address_2": "SUITE 210",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643299",
            "telephone_number": "360-254-6161",
            "fax_number": "360-449-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NE MOTHER JOSEPH PL",
            "address_2": "SUITE 110",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643299",
            "telephone_number": "360-254-6161",
            "fax_number": "360-449-1146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENFELD",
        "first_name": "BONNIE",
        "middle_name": "L.",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2007-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA10004003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8355166",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.