Michael Buonopane, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2378 Issued in MA

Practice address

161 College Ave
Medford, MA 02155-5528

Phone

(617) 627-5102

NPI assigned

Jan 17, 2017

Last updated

Jan 17, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Orthopedic and Sports Physical Therapy, LLP

  • Physical Therapist
  • Boston, MA
  • NPI 1083839450
  NPD (past)

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

{
    "created_epoch": "1484611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1275079071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 COLLEGE AVE",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021555528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 COLLEGE AVE",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021555528",
            "telephone_number": "617-627-5102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUONOPANE",
        "first_name": "MICHAEL",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-17",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MA",
            "license": "2378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Buechler, MD
• Karen Buetens, LICSW
• Theresa Bui, CPNP
• Alaa Bukhari
• Alanna Bunzel
• Johanna Burke, M.D.
• Caitlyn Burkhardt, PTA
• Amelia Colby Burns, OD
• Courtney Lynn Burns
• Edward P Butler, MD

• Athletic Trainer in Medford, MA
• Providers in Medford, MA by specialty
• Athletic Trainer in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; 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.