Individual provider Active NPI

John E Buonora, CRNA

  • Certified Registered Nurse Anesthetist
  • Tacoma, WA
National Provider Identifier
1356345185
Registry record updated Jan 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP60879305 Issued in WA
Practice address
9040 Jackson Ave
Tacoma, WA 98431-4933
Phone
(253) 968-0554
Fax
(253) 986-3278
NPI assigned
Jun 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 133435-030 WI
Certified Registered Nurse Anesthetist 367500000X AP60879305 WA Primary

Addresses

Primary practice location

9040 Jackson Ave
Tacoma, WA 98431-4933

Mailing address

10901 102ND Ave SW
Lakewood, WA 98498-2909
Phone (240) 429-8870

Other identifiers 2

IdentifierTypeStateIssuer
2141668MedicaidWA
43388700MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address john.e.buonora.civ@mail.mil Health Information Exchange (HIE)

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)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
AP60879305WAMDCertified Registered Nurse Anesthetist
133435-030WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Services of the Fox Valley SC Past Accepting new patients
Association of Hospital Anesthesiologists SC Past Accepting new patients
Nurse Anesthesia Professional Services LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Southeastern Wisconsin Anesthesiology, S.C. Past Accepting new patients

Organizations & group practices 4

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": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641600000000",
    "number": "1356345185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10901 102ND AVE SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984982909",
            "telephone_number": "240-429-8870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984314933",
            "telephone_number": "253-968-0554",
            "fax_number": "253-986-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUONORA",
        "first_name": "JOHN",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2022-01-08",
        "certification_date": "2022-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "133435-030",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP60879305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2141668",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43388700",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "john.e.buonora.civ@mail.mil",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9040 Jackson Ave",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984314933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.