Individual provider Active NPI

Ann Elizabeth Bonner

  • Physician Assistant
  • Sherman Oaks, CA
National Provider Identifier
1447905575
Registry record updated Feb 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4835 Van Nuys Blvd Ste 210
Sherman Oaks, CA 91403-2156
Phone
(818) 784-1354
NPI assigned
Feb 17, 2022
Last updated
Feb 17, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

4835 Van Nuys Blvd Ste 210
Sherman Oaks, CA 91403-2156

Mailing address

4835 Van Nuys Blvd Ste 210
Sherman Oaks, CA 91403-2156

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250919003362 PA Practitioner - Physician Assistant 3971007097 Reassigns benefits to 1 organization
I20251125004124 NJ Practitioner - Physician Assistant 3971007097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

1865 Route 70 E 220
Mus Skel Cherry Hill
Cherry Hill, NJ 08003-2013
Phone (856) 429-0505

3400 Spruce St
Philadelphia, PA 19104-4206

3400 Spruce Street 5 White BLDG
Oral and Maxillofacial Surgery Hup
Philadelphia, PA 19104-4206
Phone (215) 829-6079

800 Spruce St
Philadelphia, PA 19107-6130

800 Spruce St Cathcart Building
Penn Radiology Mobile Mammography Pennsylva
Philadelphia, PA 19107-6130
Phone (215) 829-3282

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Health Care Associates of New Jersey, PC CurrentSince Nov 3, 2025 Accepting new patients
Clinical Health Care Associates of New Jersey, P.C. CurrentSince Nov 3, 2025 Accepting new patients
University of Penn-Medical Group CurrentSince Sep 1, 2025 Accepting new patients
University of Penn-Medical Group CurrentSince Sep 1, 2025 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Past Accepting new patients
Univ of Penn-Orthopedic Surgery PastSince May 10, 2015 Accepting new patients

Locations

1865 Route 70 E
Ste 220
Cherry Hill, NJ 08003
Phone (856) 429-0505

1006 Mantua Pike
Woodbury Hts, NJ 08097
Phone (856) 845-6880

PO B0x 824320
Philadelphia, PA 19182

800 Spruce St
#1
William Penn Annex West, PA 19107
Phone (215) 829-2222

Organizations & group practices 7

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1645056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1447905575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4835 VAN NUYS BLVD STE 210",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914032156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4835 VAN NUYS BLVD STE 210",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914032156",
            "telephone_number": "818-784-1354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNER",
        "first_name": "ANN",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-17",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

Verify at the official NPI Registry.