John Mark Carlos Bonagua, AGNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

308120 Issued in NY

Practice address

612 Allerton Ave
Bronx, NY 10467-7404

Phone

(718) 519-4029

NPI assigned

Jul 31, 2017

Sex

Male

Sole proprietor

No

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 NY

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 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

David Tavdy Medical Care PCGroup PAC ID 1052655966, 2 clinicians

Medical Director Services PCGroup PAC ID 0042501116, 79 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• David Tavdy Medical Care PC

  • Internal Medicine Physician
  • Forest Hills, NY
  • NPI 1245746064
  Medicare reassignment Care Compare group NPD
• Medical Director Services PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Princess Anne, MD
  • NPI 1871955807

  NY

  Medicare reassignment Care Compare group NPD
• Parcare Community Health Network Inc

  • Multi-Specialty Clinic/Center
  • Brooklyn, NY
  • NPI 1730454083
  Medicare reassignment NPD
• Park Avenue Pediatrics, P.C.

  • Pediatrics Physician
  • Spring Valley, NY
  • NPI 1699969543
  Medicare reassignment NPD
• Patient First Medical Practice PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Brooklyn, NY
  • NPI 1255067955
  Medicare reassignment NPD
• JDS Medical Services PC

  • Emergency Medicine Physician
  • Englewood, NJ
  • NPI 1174224653

  NY

  Medicare reassignment NPD
• Linda Podiatry PC

  • Podiatrist
  • New York, NY
  • NPI 1356623771
  NPD
• Parcare Community Health Network Inc

  • Multi-Specialty Clinic/Center
  • Brooklyn, NY
  • NPI 1942795943
  NPD

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

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505088000000",
    "number": "1477077535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 ALLERTON AVENUE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10467",
            "telephone_number": "718-519-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 ALLERTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104677404",
            "telephone_number": "718-519-4029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONAGUA",
        "first_name": "JOHN MARK",
        "middle_name": "CARLOS",
        "name_prefix": "Mr.",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-31",
        "last_updated": "2017-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "308120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oluwafunmilayo Bomide, RN
• Ramamohan Bommareddy
• Anne Bonache, P.T.
• Susan Bonadonna, MD
• Sandra Bonafont
• Kehana Bonagura
• Joseph Bonanno, D.O.
• Lisa Ivy Bond
• Tiana Bond, MSW
• Kgomotso P Bonda, DO

• Adult Health Nurse Practitioner in Bronx, NY
• Providers in Bronx, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2017; 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.