Jeremy Bonzo, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

50642 Issued in KY

Practice address

336 29TH St Ste 101
Ashland, KY 41101-1976

Phone

(606) 324-4404

NPI assigned

Jun 6, 2012

Last updated

Nov 18, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KY

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

Urology

Education

University of Kentucky College of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kings Daughters Medical Specialties IncGroup PAC ID 6103968029, 397 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• King's Daughters' Medical Center Hospital, Ashland, KY, CCN 180009
• Kings Daughters Medical Center Ohio Hospital, Portsmouth, OH, CCN 360361

Merit-based Incentive Payment System (MIPS)

Final score

84.04 of 100Reported as group

Quality

60.55

Promoting interoperability

100

Improvement activities

40

Cost

78.81

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jbonzo72586@direct.kdhealth.us

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kings Daughters Medical Specialties Inc

  dba Kings Daughters Medical Specialities Physical Medicine and Rehab

  • Physical Medicine & Rehabilitation Physician
  • Prestonsburg, KY
  • NPI 1710215736
  Medicare reassignment Care Compare group NPD
• Kings Daughters Medical Specialties Inc

  dba Kings Daughters Medical Specialties Tri State Regional Cancer Center

  • Radiation Oncology Physician
  • Ashland, KY
  • NPI 1699565176
  NPD
• Kings Daughters Medical Specialties Inc

  dba Kings Daughters Medical Specialties Bluegrass Urology

  • Cardiovascular Disease Physician
  • Ashland, KY
  • NPI 1972830404

  Urology

  NPD

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

• Ashland Hospital Corporation

  dba Kings Daughters Medical Center

  • General Acute Care Hospital
  • Ashland, KY
  • NPI 1851346720
  Care Compare affiliation
• Portsmouth Hospital Corporation

  dba King's Daughters Medical Center - Ohio

  • General Acute Care Hospital
  • Portsmouth, OH
  • NPI 1417227398
  Care Compare affiliation

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1447511332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2379",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411052379",
            "telephone_number": "606-408-6200",
            "fax_number": "606-408-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 29TH ST STE 101",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411011976",
            "telephone_number": "606-324-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONZO",
        "first_name": "JEREMY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-06",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PA",
            "license": "MT202082",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "KY",
            "license": "50642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100485660",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbonzo72586@direct.kdhealth.us",
            "affiliation": "N",
            "endpointDescription": "EMAIL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "TXT",
            "address_1": "336 29th St Ste 101",
            "city": "Ashland",
            "state": "KY",
            "country_code": "US",
            "postal_code": "411011976",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Magdalene Elizabeth Boggs
• Megan Boggs, PT, DPT
• Gina Leann Bohanon, MSN, APRN, FNP-C
• Tonya Michelle Bond-Judd
• John (Jack) Kenneth Borders Jr., M.D.
• George Carl Borst, M.D.
• Bill Hunter Boshell, MD
• Christina Marie Bostick, LCSW
• Bostiga Pediatric Therapy, LLC (Bostiga Pediatric Therapy)

• Urology Physician in Ashland, KY
• Providers in Ashland, KY by specialty
• Urology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; 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.