Individual provider Active NPI

Heidi P Bonaroti, OT

  • Occupational Therapist
  • Phoenix, AZ
National Provider Identifier
1225257843
Registry record updated Dec 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1472 Issued in AZ
Practice address
1802 W Parkside LN
Phoenix, AZ 85027-1322
Phone
(480) 510-4219
NPI assigned
Apr 24, 2007
Last updated
Dec 9, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1472 AZ Primary

Addresses

Primary practice location

1802 W Parkside LN
Phoenix, AZ 85027-1322

Mailing address

1802 W Parkside LN
Phoenix, AZ 85027-1322
Phone (480) 510-4219

Other identifiers 1

IdentifierTypeStateIssuer
791568MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080128000097 AZ Practitioner - Occupational Therapist in Private Practice 7911089115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neurologic Therapy Specialists LLCGroup PAC ID 8921100082, 5 clinicians

Practice addresses (Care Compare)

5017 E Washington St
Phoenix, AZ 85034-2033
Phone (602) 277-1073

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1472AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Neurologic Therapy Specialists LLC CurrentSince Mar 25, 2022 Accepting new patients
Neuro Institute, Inc Past Accepting new patients

Locations

5017 E Washington St
Ste 107
Phoenix, AZ 85034
Phone (480) 565-2276

5017 E Washington St
Ste 107A
Phoenix, AZ 85034
Phone (602) 277-1073

5055 E Washington St
Ste 125
Phoenix, AZ 85034
Phone (602) 277-1073

Organizations & group practices 2

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": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228780800000",
    "number": "1225257843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 W PARKSIDE LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850271322",
            "telephone_number": "480-510-4219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 W PARKSIDE LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850271322",
            "telephone_number": "480-510-4219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONAROTI",
        "first_name": "HEIDI",
        "middle_name": "P",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2008-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "1472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "791568",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.