Lisa Marie Bonvino, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

223033 Issued in NY

Practice address

101 Hospital Rd
Patchogue, NY 11772-4870

Phone

(631) 447-3048

NPI assigned

Nov 17, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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

Specialty

Psychiatry

Education

New York College of Osteo Medicine of New York Institute of Technology, 1998

Medicare assignment

May accept Medicare assignment

Group practices

The Long Island HomeGroup PAC ID 8224055108, 22 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
• NS/Lij HS Southside Hospital Hospital, Bay Shore, NY, CCN 330043

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lbonvino1705207@nychhc.direct-ci.com
• Direct secure messaging: lisa.bonvino@direct.stonybrookmedicine.edu

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.

• The Long Island Home

  dba South Oaks Hospital

  • Psychiatric Hospital
  • Amityville, NY
  • NPI 1821394016
  Medicare reassignment Care Compare group NPD
• The Long Island Home

  dba South Oaks Hospital

  • Psychiatric Hospital
  • Amityville, NY
  • NPI 1568459204
  NPD
• Federation Employment and Guidance Service, Inc

  • Developmental Disabilities Clinic/Center
  • New York, NY
  • NPI 1942243084
  NPD (past)
• Neurology Associates of Stony Brook, University Faculty Practice Corpo

  • Neurology Physician
  • Stony Brook, NY
  • NPI 1699720888
  NPD (past)

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

• North Shore University Hospital

  • General Acute Care Hospital
  • Manhasset, NY
  • NPI 1366459570
  Care Compare affiliation
• South Shore University Hospital

  • General Acute Care Hospital
  • Bay Shore, NY
  • NPI 1457369381
  Care Compare affiliation

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376617944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 INGELORE CT",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117871705",
            "telephone_number": "631-724-4859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HOSPITAL RD",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117724870",
            "telephone_number": "631-447-3048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONVINO",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "223033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blum's Corset Shop of Patchogue Inc.
• Robert Bobrow, M.D.
• Body Listen Acupuncture, P.C.
• Laura Ann Boehmann
• Courtney Bofinger, PA
• Rubina Boparai, MD
• Leonard Howard Boretz, DDS
• Margarita Bou, RN
• Danielle M Bousquet
• Bernice Bouzy

• Psychiatry Physician in Patchogue, NY
• Providers in Patchogue, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.