Susanna Bomfim, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MB11136600 Issued in NJ

Practice address

800 Morris Tpke
Short Hills, NJ 07078-2698

Phone

(908) 273-4300

NPI assigned

May 27, 2019

Last updated

Aug 10, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Susanna Woolston Former name

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Atlantic Visiting Nurse Home health agency, Morristown, NJ, CCN 317054
• Overlook Medical Center Hospital, Summit, NJ, CCN 310051

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: susanna.bomfim.1@2983.direct.athenahealth.com

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.

• Summit Medical Group PA

  • Multi-Specialty Clinic/Center
  • Berkeley Heights, NJ
  • NPI 1942254347
  Medicare reassignment Care Compare group NPD
• Patient First Maryland Physician's Group PC

  • Family Medicine Physician
  • Glen Allen, VA
  • NPI 1982733564

  NJ

  Medicare reassignment NPD
• Patients First Maryland Physicians Group P C

  • Family Medicine Physician
  • Cherry Hill, NJ
  • NPI 1114477270
  NPD
• Summit Medical Group PA

  • Durable Medical Equipment & Medical Supplies
  • Hackensack, NJ
  • NPI 1043930555
  NPD
• Summit Medical Group, Inc

  dba St. Elizabeth Physicians

  • Family Medicine Physician
  • Erlanger, KY
  • NPI 1750343216
  NPD (past)

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

• Ahs Hospital Corp.

  dba Overlook Hospital

  • General Acute Care Hospital
  • Summit, NJ
  • NPI 1740254143
  Care Compare affiliation
• Ahs Hospital Corp.

  dba Atlantic Home Care & Hospice

  • Home Health Agency
  • Morristown, NJ
  • NPI 1962479667
  Care Compare affiliation

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

{
    "created_epoch": "1558915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1295392108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104",
            "telephone_number": "973-577-5825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MORRIS TPKE",
            "city": "SHORT HILLS",
            "state": "NJ",
            "postal_code": "070782698",
            "telephone_number": "908-273-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMFIM",
        "first_name": "SUSANNA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-27",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB11136600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSANNA",
            "last_name": "WOOLSTON",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• BH ABA Services LLC
• Pankaj Kumar Bhandari, M.D.
• Silvia Susana Bilobron, DMD
• Melissa Mary Blatt, RN
• Blue ABA New Jersey LLC
• Bond of Love Caregivers
• Joshua Bourne
• Valerie Ann Brackett, M.D.
• Alison Marie Breen, APN
• Alyssa Bressler, PH.D.

• Family Medicine Physician in Short Hills, NJ
• Providers in Short Hills, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.
• 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.