Susan Bonfiglio, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

383 Issued in CO

Practice address

4212 N 16TH St
Phoenix, AZ 85016-5319

Phone

(602) 200-5325

Fax

(602) 200-5335

NPI assigned

Jan 5, 2006

Last updated

Mar 19, 2008By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205884800000",
    "number": "1427036847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4212 N 16TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165319",
            "telephone_number": "602-200-5325",
            "fax_number": "602-200-5335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4212 N 16TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165319",
            "telephone_number": "602-200-5325",
            "fax_number": "602-200-5335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONFIGLIO",
        "first_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-05",
        "last_updated": "2008-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "97375578",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristal Ann Bonelli
• Margaret Sue Bonesteel, M.A.
• Jacob Boney, PSY.D., BCBA-D
• Chelsea Caterino Bonfiglio, MD
• Roxanne Bonfiglio, PSY.D.
• Sara Bonham
• Emmanuel Bonilla-Segura, PT, DPT
• Adriana A Bonilla
• Briauna Mae Bonilla
• Gabriel L Bonilla, MD

• Medical Physician Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.