Individual provider Active NPI

Danielle Esther Bonasera, LMSW

  • Social Worker
  • Smithtown, NY
National Provider Identifier
1316618564
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
113632 Issued in NY
Practice address
1056 W Jericho Tpke
Smithtown, NY 11787-3212
Phone
(631) 972-4551
NPI assigned
Sep 27, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 113632 NY Primary

Addresses

Primary practice location

1056 W Jericho Tpke
Smithtown, NY 11787-3212

Mailing address

17 Sunhill Rd
Nesconset, NY 11767-2610
Phone (631) 972-4551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
113632NYMDDiagnostic Radiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1632700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1316618564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 SUNHILL RD",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117672610",
            "telephone_number": "631-972-4551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1056 W JERICHO TPKE",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873212",
            "telephone_number": "631-972-4551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONASERA",
        "first_name": "DANIELLE",
        "middle_name": "ESTHER",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-27",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "113632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.