Ted Arthur Bonebrake, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

32655 Issued in IA

Practice address

3640 Canterbury CT Ste B
Waterloo, IA 50702-5705

Phone

(319) 595-1181

NPI assigned

May 28, 2013

Last updated

Jan 30, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• New Life Family Medicine P.C.

  • Family Medicine Physician
  • Creston, IA
  • NPI 1376798066
  NPD (past)

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

{
    "created_epoch": "1369699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1356788616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3640 CANTERBURY CT STE B",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025705",
            "telephone_number": "319-595-1181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3640 CANTERBURY CT STE B",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025705",
            "telephone_number": "319-595-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONEBRAKE",
        "first_name": "TED",
        "middle_name": "ARTHUR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-28",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "32655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sierra Boike-Thompson
• Deanne K Bolhuis, A.R.N.P.
• Samira Bolic
• Kate Elizabeth Bolick, ARNP
• William C Bolick, D.D.S.
• Abigail Jo Bonner
• Heidi M Bonthuis, PA--C
• Staci Anne Boon, O.D.
• Kimberly A Boote, C.N.M.
• Britney Borcherding

• Family Medicine Physician in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.