Marie L Bonvicino, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

25MA06624300 Issued in NJ

Practice address

222 Oak Ave
Toms River, NJ 08753-3348

Phone

(732) 914-1919

Fax

(732) 341-3303

NPI assigned

Jun 19, 2006

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

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in NJ

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

Obstetrics/Gynecology

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lifeline Medical Associates LLCGroup PAC ID 1456332170, 155 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Medical Center Hospital, Toms River, NJ, CCN 310041
• Ocean Medical Center Hospital, Brick, NJ, CCN 310052
• Monmouth Medical Center Hospital, Long Branch, NJ, CCN 310075
• Centrastate Medical Center Hospital, Freehold, NJ, CCN 310111

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marie.bonvicino.1@27010.direct.athenahealth.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Lifeline Medical Associates, LLC

  • Obstetrics & Gynecology Physician
  • Florham Park, NJ
  • NPI 1821041617
  Medicare reassignment Care Compare group NPD

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

• Centrastate Medical Center, Inc

  • General Acute Care Hospital
  • Freehold, NJ
  • NPI 1295718450
  Care Compare affiliation
• Community Medical Center Inc

  • General Acute Care Hospital
  • Toms River, NJ
  • NPI 1013010917
  Care Compare affiliation
• HMH Hospitals Corporation

  • General Acute Care Hospital
  • Brick, NJ
  • NPI 1477065126
  Care Compare affiliation
• HMH Hospitals Corporation

  • Clinical Medical Laboratory
  • Brick, NJ
  • NPI 1942927538

  Hospital

  Care Compare affiliation
• Monmouth Medical Center Inc

  • General Acute Care Hospital
  • Long Branch, NJ
  • NPI 1609983790
  Care Compare affiliation

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407891609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 OAK AVE",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087533348",
            "telephone_number": "732-914-1919",
            "fax_number": "732-341-3303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 OAK AVE",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087533348",
            "telephone_number": "732-914-1919",
            "fax_number": "732-341-3303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONVICINO",
        "first_name": "MARIE",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA06624300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH NJ PA DEL",
            "identifier": "0062754000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA COMED",
            "identifier": "3023421",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7653506",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET PHS",
            "identifier": "G02909",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P732138",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ST BARNABAS HEALTH",
            "identifier": "010066243NJ01",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH ADMIN",
            "identifier": "341407",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HMO",
            "identifier": "3023421001",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victoria Bolles
• Matthew Bompastore, MD
• Brian Lee Bones, MD
• Don Lennin Bonifacio, PHYSICAL THERAPIST
• R-Phinne Supena Bonifacio, PT
• Jyoti Borate, DPM
• Marion A Borbely, RPH
• Richard Joseph Borgatti Jr., MD
• Christine Marie Borkes
• Gregory Michael Borsuk, M.D.

• Specialist in Toms River, NJ
• Providers in Toms River, NJ by specialty
• Specialist in New Jersey

• 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.