Mary Elizabeth Bonafede, M.D.

Primary specialty

Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X

License

208119 Issued in NY

Practice address

239 Higbie LN
West Islip, NY 11795-2825

Phone

(631) 376-3000

NPI assigned

Oct 24, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Optum Medical Care, P.C.

  dba CareMount Medical, P.C.

  • Cardiovascular Disease Physician
  • Mount Kisco, NY
  • NPI 1982643003
  Medicare reassignment NPD
• Optum Medical Care, P.C.

  • Durable Medical Equipment & Medical Supplies
  • New Hyde Park, NY
  • NPI 1053190595
  NPD
• Mount Kisco Medical Group

  • Hematology (Internal Medicine) Physician
  • Fishkill, NY
  • NPI 1952356362
  NPD (past)

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376627661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 S MONTGOMERY AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068808",
            "telephone_number": "631-969-3865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 HIGBIE LN",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117952825",
            "telephone_number": "631-376-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONAFEDE",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "NY",
            "license": "208119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Grace Bober, D.O.
• Wojciech Bober, D.O.
• Jill Anne Bocchieri
• Rao Bodapati, MD
• Nicole Boeckel, FNP
• Jacqueline Bonamassa
• Samantha Bonatti, PT
• Brittany Bongiovi, PA-C
• Stephanie Marie Bonura, PA-C
• Borimir Darakchiev MD PC

• Pediatric Infectious Diseases Physician in West Islip, NY
• Providers in West Islip, NY by specialty
• Pediatric Infectious Diseases 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.