Individual provider Active NPI

Joel R Bonamo, MD

  • Orthopaedic Surgery Physician
  • Staten Island, NY
National Provider Identifier
1316900657
Registry record updated Jul 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
132853 Issued in NY
Practice address
1551 Richmond Rd
Staten Island, NY 10304
Phone
(718) 351-6500
Fax
(718) 351-7672
NPI assigned
Apr 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 132853 NY Primary

Addresses

Primary practice location

1551 Richmond Rd
Staten Island, NY 10304

Mailing address

1551 Richmond Rd
Staten Island, NY 10304
Phone (718) 351-6500

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101027000011 NY Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 2163510066 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Amboy Medical Practice PC CurrentSince Sep 1, 2016 Accepting new patients
Staten Island Orthopedics & Sports Medicine P.C Orthopaedic Surgery CurrentSince Jan 1, 2003 Accepting new patients
Amboy Medical Practice PC CurrentSince Sep 1, 2016 Accepting new patients

Locations

9920 4th Ave
Ste 102
Brooklyn, NY 11209
Phone (718) 238-9873

1551 Richmond Rd
#S
Staten Island, NY 10304
Phone (718) 351-6500

4434 Amboy Rd
Staten Island, NY 10312
Phone (718) 818-1015

1551 Richmond Rd
Staten Island, NY 10304
Phone (718) 351-6500

2052 Richmond Rd
Staten Island, NY 10306
Phone (718) 351-6500

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278460800000",
    "number": "1316900657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 RICHMOND RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10304",
            "telephone_number": "718-351-6500",
            "fax_number": "718-351-7672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 RICHMOND RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10304",
            "telephone_number": "718-351-6500",
            "fax_number": "718-351-7672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONAMO",
        "first_name": "JOEL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-08",
        "last_updated": "2010-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "132853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.