Lauren Elizabeth Bonomo, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD61288641 Issued in WA

Practice address

11800 NE 128TH St Ste 450
Kirkland, WA 98034-7211

Phone

(425) 899-3376

Fax

(425) 899-4131

NPI assigned

Mar 30, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Dermatology

Education

Icahn School of Medicine at Mount Sinai, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Associates of San AntonioGroup PAC ID 1759319296, 17 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lauren.bonomo.p1@direct.dermsa.nextgenshare.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.

• Dermatology Associates of San Antonio

  • Dermatology Physician
  • Live Oak, TX
  • NPI 1487661518

  Single Specialty, TX

  Medicare reassignment Care Compare group NPD
• Epiphany Dermatology PA

  • Dermatology Physician
  • Waco, TX
  • NPI 1043615263

  Single Specialty, TX

  Medicare reassignment NPD
• Kirkland Dermatology Associates, PLLC

  • Medical Specialty Clinic/Center
  • Kirkland, WA
  • NPI 1447314661

  Single Specialty

  NPD

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

{
    "created_epoch": "1522368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1477059442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 NE 128TH ST STE 450",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980347211",
            "telephone_number": "425-899-3376",
            "fax_number": "425-899-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 NE 128TH ST STE 450",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980347211",
            "telephone_number": "425-899-3376",
            "fax_number": "425-899-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONOMO",
        "first_name": "LAUREN",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-30",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD61288641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelyn Boehm, OTR/L
• Jamika L Bolar
• Amanda Bolton
• Bonnie Bhatti PHD Licsw LLC
• Bonnie J McIntosh, PHD, PS
• Jessica Bontempo, LMP
• Erica Bonthuis
• Karsen Bontrager
• Catherine Booms, MD
• Susie Bordner

• All providers in Kirkland, WA
• Dermatology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; 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.