Active NPI
Lauren Bonomi
- Physician Assistant
- New York, NY
National Provider Identifier
1285496034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 525 E 68TH St
New York, NY 10065-4870 - Phone
- (888) 426-7787
- NPI assigned
- Jan 26, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
525 E 68TH St
New York, NY 10065-4870
Mailing address
11 Evon LN
Saint James, NY 11780-2512
Phone (631) 560-8483
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260206003553 | NY | Order and Referring Only - Physician Assistant | 4183103401 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706227200000",
"number": "1285496034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 EVON LN",
"city": "SAINT JAMES",
"state": "NY",
"postal_code": "117802512",
"telephone_number": "631-560-8483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 E 68TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100654870",
"telephone_number": "888-426-7787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONOMI",
"first_name": "LAUREN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-26",
"last_updated": "2024-01-26",
"certification_date": "2024-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.