Bonnie Vader, DPM, PC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

N004730 Issued in NY

Legal business name

BONNIE VADER, DPM, PC

Practice address

621 Amboy St
Suite 1
Brooklyn, NY 11212-4724

Phone

(718) 345-2935

Fax

(718) 345-2940

NPI assigned

May 18, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Bonnie Vader, DPMNPI 1285639294

Title

President

Phone

(718) 345-2935

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bonnie Vader, DPM

  • Podiatrist
  • Brooklyn, NY
  • NPI 1285639294
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352419200000",
    "number": "1437367794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 RUBY LN",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118033822",
            "telephone_number": "516-931-0430",
            "fax_number": "516-827-1971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 AMBOY ST",
            "address_2": "SUITE 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112124724",
            "telephone_number": "718-345-2935",
            "fax_number": "718-345-2940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONNIE VADER, DPM, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2012-11-09",
        "status": "A",
        "authorized_official_last_name": "VADER",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-345-2935",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N004730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "KS581",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI MEDICARE",
            "identifier": "A100000081",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1247630",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jamyica Bonner
• Jasaun Jerome Anthony Bonner Sr.
• Jennifer Marie Bonner, MS ED.
• Kathleen A Bonner, TEACHER-VISION
• Claude-Luvier Bonnet, FNP
• Madonna Bonny, MS.ED, BCBA, LBA
• Sandra E Bonny, LPN
• Lea Viviana Bono, OTR/L
• Valerie Bono, PA
• Monsurat Bonojo, NP

• Podiatrist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.