Active NPI
Paul Buonaguro, RPH
- Pharmacist
- Massapequa, NY
National Provider Identifier
1295903813
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 042398-1
- Practice address
- 5508 Sunrise Hwy
Massapequa, NY 11758-5328 - Phone
- (516) 797-9672
- Fax
- (516) 797-9674
- NPI assigned
- Feb 16, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 042398-1 | NY | Primary |
| Pharmacist | 183500000X | PS 28416 | FL |
Addresses
Primary practice location
5508 Sunrise Hwy
Massapequa, NY 11758-5328
Mailing address
17 Connecticut Ave
Massapequa, NY 11758-4402
Phone (516) 521-4822
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 042398-1 | Other | NY | NY STATE LICENSE |
| PS 28416 | Other | FL | FLORIDA STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 042398-1 | NY | MD | General Practice Dentistry |
| PS 28416 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Waldbaum Inc | Past | Accepting new patients |
Organizations & group practices 1
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": "1203120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203120000000",
"number": "1295903813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 CONNECTICUT AVE",
"city": "MASSAPEQUA",
"state": "NY",
"postal_code": "117584402",
"telephone_number": "516-521-4822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5508 SUNRISE HWY",
"city": "MASSAPEQUA",
"state": "NY",
"postal_code": "117585328",
"telephone_number": "516-797-9672",
"fax_number": "516-797-9674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUONAGURO",
"first_name": "PAUL",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-02-16",
"last_updated": "2008-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "042398-1",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS 28416",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NY STATE LICENSE",
"identifier": "042398-1",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLORIDA STATE LICENSE",
"identifier": "PS 28416",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Massapequa, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.