Gwen Lindsey Bonner, M.D.
Individual provider Active NPI Surgery Physician · Potsdam, NY
NPI 1386901015 · NPPES record last updated Jul 10, 2024
Key facts
- NPI
- 1386901015
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgery Physician 208600000X
- License
- 292640-1 (NY)
- Practice address
- 50 Leroy St
Potsdam, NY 13676-1786 - Phone
- (315) 265-3300
- Fax
- (315) 379-0849
- NPI assigned
- Apr 19, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- General Surgery
- Education
- Texas a & M University System, HSC, College of Medicine, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Canton-Potsdam Hospital
Practice addresses (Care Compare)
80 E Main St
Canton, NY 13617-1450
Phone (315) 386-3300
Hospital & facility affiliations
- Canton-Potsdam Hospital
- SLHS Massena, Inc
Merit-based Incentive Payment System (MIPS)
- Final score
- 98.56 of 100
- Quality
- 87.76
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 54 |
| Hernia repair - groin (open) | 1-10 |
| Hernia repair (minimally invasive) | 1-10 |
| Mastectomy | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 37 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 1-10 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180913000043 | NY | Practitioner - General Surgery | 0042591240 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 292640-1 | NY | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Canton-Potsdam Hospital | Current |
Accepting new patients | |
| Canton-Potsdam Medical Practice PLLC | Current |
Accepting new patients | |
| Canton-Potsdam Hospital | Current |
Accepting new patients | |
| Canton Potsdam Hospital | Past |
Accepting new patients |
Locations
80 E Main St
Canton, NY 13617
Phone (315) 261-6034
50 Leroy St
Potsdam, NY 13676
Phone (315) 261-6034
25 Cottage St
Potsdam, NY 13676
Phone (315) 261-6034
201 Market St
Ste E
Potsdam, NY 13676
Phone (315) 274-9102
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 35.129611 | OH | |
| Surgery Physician | 208600000X | 292640-1 | NY | Yes |
Addresses
Primary practice location
50 Leroy St
Potsdam, NY 13676-1786
Mailing address
50 Leroy St
Potsdam, NY 13676-1786
Phone (315) 265-3300
Other practice location 1
80 E Main St
Canton, NY 13617-1450
Phone (315) 379-9460
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | gbonner333261@direct.rochesterregional.org |
Other providers in Potsdam, NY
- Noel Lawton Bloomfield II
- Bodyworks Chiropractic
- Jean Quinn Bogart
- Coreen Bohl
- Bridget Bond
- Megan Lyn Boyea
- Emma Brackett
- Brent S. Knight - Knight & Associates Physical Therapy
- Phillip Moses Bridgman
- William Bronner VI
All providers in Potsdam, NY · Surgery Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.