Giovanni Bonomo, M.D.

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

297392-1 Issued in NY

Practice address

256 Mason Ave BLDG C3
Staten Island, NY 10305-3408

Phone

(718) 226-6398

NPI assigned

Apr 16, 2011

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA, NY2 enrollments

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 2

Specialty

Colorectal Surgery (Proctology)

Education

State University of New York at Stony Brook, School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Shore Home Care Chha Home health agency, Westbury, NY, CCN 337148
• Staten Island University Hospital Hospital, Staten Island, NY, CCN 330160

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678

Interoperability endpoints

• Direct secure messaging: gbonomo65055@northwell.direct-ci.com

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.

• North Shore-Lij Medical PC

  dba NHPP Cardiology at Great Neck

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572

  Colon & Rectal Surgery

  Medicare reassignment Care Compare group NPD
• Colon Rectal Surgery Associates PC

  • Colon & Rectal Surgery Physician
  • Allentown, PA
  • NPI 1629027388
  Medicare reassignment NPD
• Lehigh Valley Physician Group

  dba LVPG Developmental Pediatrics

  • Developmental - Behavioral Pediatrics Physician
  • Allentown, PA
  • NPI 1780155689
  Medicare reassignment
• Lehigh Valley Physician Group

  dba LVPG Family and Internal Medicine - East Stroudsburg

  • Family Medicine Physician
  • East Stroudsburg, PA
  • NPI 1245093368
  NPD
• Lehigh Valley Physician Group

  dba LVPG Internal Medicine - East Stroudsburg

  • Internal Medicine Physician
  • East Stroudsburg, PA
  • NPI 1285499137
  NPD
• Lehigh Valley Physician Group

  • Transplant Surgery Physician
  • Allentown, PA
  • NPI 1457309650
  NPD
• Staten Island University Hospital

  • General Acute Care Hospital
  • Staten Island, NY
  • NPI 1407877137
  NPD (past)

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

• North Shore University Hospital

  • Home Health Agency
  • Manhasset, NY
  • NPI 1417965278
  Care Compare affiliation
• North Shore University Hospital

  • Home Health Agency
  • Westbury, NY
  • NPI 1861464471
  Care Compare affiliation
• Staten Island University Hospital

  • General Acute Care Hospital
  • Staten Island, NY
  • NPI 1407877137
  Care Compare affiliation

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

{
    "created_epoch": "1302912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1386934917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 MASON AVE BLDG C3",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053408",
            "telephone_number": "718-226-6398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 MASON AVE BLDG C3",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053408",
            "telephone_number": "718-226-6398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONOMO",
        "first_name": "GIOVANNI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-16",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NY",
            "license": "297392-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103336973",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Bonilla, LMHC
• Mildred Pabua Bonilla, RN
• Julia Bonoan
• Marcus Salvador Bonoan, MD
• Donna Angela Bonomi, MS/PT
• Natalie M Bonomo, PA-C
• Jaime Bonura
• Steven Bonvino, MD
• Allen Luther Boone III, CRPA - P
• Deborah Edith Boone

• Colon & Rectal Surgery Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Colon & Rectal Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 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.