NPIMap

Individual provider Active NPI

Joseph Bonomini, PA

  • Physician Assistant
  • Lawrenceburg, IN
National Provider Identifier
1225439698
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10001721A Issued in IN
Practice address
605 Wilson Creek Rd
Lawrenceburg, IN 47025-2506
Phone
(859) 301-2663
Fax
(859) 817-7848
NPI assigned
Sep 4, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10001721A IN Primary

Addresses

Primary practice location

605 Wilson Creek Rd
Lawrenceburg, IN 47025-2506

Mailing address

560 S Loop Rd
Edgewood, KY 41017-3405
Phone (859) 301-2663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20141231000228 IN Practitioner - Physician Assistant 4284957044 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthocincy Orthopaedics and Sports Medicine PSCGroup PAC ID 3173500196, 163 clinicians

Practice addresses (Care Compare)

1600 Flossie Dr
Greendale, IN 47025-8424
Phone (859) 301-2663

605 Wilson Creek Rd
Lawrenceburg, IN 47025-2506
Phone (859) 301-2663

Hospital & facility affiliations

  • St Elizabeth Dearborn Hospital Hospital, Lawrenceburg, IN, CCN 150086
  • St Elizabeth Edgewood Hospital, Edgewood, KY, CCN 180035

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orthocincy Orthopaedics & Sports Medicine PSC Physician Assistant CurrentSince Jan 25, 2021 Accepting new patients
Summit Medical Group, Inc. CurrentSince Dec 9, 2020 Accepting new patients
Summit Medical Group, Inc. Physician Assistant CurrentSince Dec 9, 2020 Accepting new patients
Orthocincy Orthopaedics & Sports Medicine PSC CurrentSince Jan 25, 2021 Accepting new patients

Locations

204 Bridgeway St
Aurora, IN 47001
Phone (812) 926-3133

605 Wilson Creek Rd
Lawrenceburg, IN 47025
Phone (812) 496-8779

272 Bielby Rd
Lawrenceburg, IN 47025
Phone (812) 537-8402

1600 Flossie Dr
Lawrenceburg, IN 47025
Phone (812) 539-2313

600 Wilson Creek Rd
Lawrenceburg, IN 47025
Phone (812) 532-2700

560 S Loop Rd
Edgewood, KY 41017
Phone (859) 817-3599

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1409788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1225439698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 S LOOP RD",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173405",
            "telephone_number": "859-301-2663",
            "fax_number": "859-817-7848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 WILSON CREEK RD",
            "city": "LAWRENCEBURG",
            "state": "IN",
            "postal_code": "470252506",
            "telephone_number": "859-301-2663",
            "fax_number": "859-817-7848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONOMINI",
        "first_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-04",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001721A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceburg, IN

Sources for this page

Verify at the official NPI Registry.