Susan M Bordonaro, DCNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NPP34886 Issued in RI

Practice address

102 Valley Rd
Middletown, RI 02842-5237

Phone

(401) 239-1800

Fax

(401) 239-1801

NPI assigned

Sep 14, 2006

Sex

Female

Sole proprietor

No

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.

• Dartmouth Dermatology Associates, PC

  • Dermatology Physician
  • Dartmouth, MA
  • NPI 1942360003

  MA

  Medicare reassignment Care Compare group NPD
• Wellcare Inc

  • Women's Health Nurse Practitioner
  • Johnston, RI
  • NPI 1235182783

  RI

  Medicare reassignment NPD
• Lydia L Klufas, M.D.

  • Specialist
  • Cumberland, RI
  • NPI 1952406951

  RI

  Medicare reassignment
• Rhode Island Dermatology & Cosmetic Center LLC

  • Specialist
  • Lincoln, RI
  • NPI 1972676021
  NPD (past)
• Southcoast Physicians Group, Inc.

  • Family Medicine Physician
  • Fairhaven, MA
  • NPI 1336137629
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Southcoast Hospitals Group, Inc

  • General Acute Care Hospital
  • Wareham, MA
  • NPI 1922024835

  Hospital

  Care Compare affiliation

Specialty

Nurse Practitioner

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dartmouth Dermatology Associates, PC 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southcoast Hospitals Group Hospital, Fall River, MA, CCN 220074

Medicare fee-for-service enrollment

Enrolled in RI, MA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sbordonaro@directaddress.net

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 30, 2020.

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1366547358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 VALLEY RD",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "028425237",
            "telephone_number": "401-239-1800",
            "fax_number": "401-239-1801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 VALLEY RD",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "028425237",
            "telephone_number": "401-239-1800",
            "fax_number": "401-239-1801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1525 Wampanoag Trl Ste 203",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "RI",
            "postal_code": "029151038",
            "country_code": "US",
            "telephone_number": "401-239-1800",
            "fax_number": "401-239-1801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "851 Main St",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "RI",
            "postal_code": "028854402",
            "country_code": "US",
            "telephone_number": "401-239-1800",
            "fax_number": "401-239-1801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "618 Toll Gate Rd",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028862717",
            "country_code": "US",
            "telephone_number": "401-239-1800",
            "fax_number": "401-239-1801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "67 William S Canning Blvd",
            "address_purpose": "LOCATION",
            "city": "Tiverton",
            "state": "RI",
            "postal_code": "028783003",
            "country_code": "US",
            "telephone_number": "401-239-1800",
            "fax_number": "401-239-1801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1524 Atwood Ave Ste 321",
            "address_purpose": "LOCATION",
            "city": "Johnston",
            "state": "RI",
            "postal_code": "029193228",
            "country_code": "US",
            "telephone_number": "401-239-1800",
            "fax_number": "401-239-1801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORDONARO",
        "first_name": "SUSAN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "DCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "RI",
            "license": "CAPRN00998",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "RI",
            "license": "NPP34886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seth Bock, D.A.
• Micolene K Boddie, MSPT
• Elizabeth Bondarevskis-Mott, REGISTERED NURSE
• Guerrino Boni, MSPT
• Megan Booher
• David Boscia, LCSW
• Ashley Botelho, COTA/L
• Kristin Diane Boudreau, D.AC., L.AC.
• Michelle A Boyle, MD
• Gwynne A Bragdon, M.D.

• All providers in Middletown, RI
• Nurse Practitioner in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.