NPIMap

Individual provider Active NPI

Monte M Bonneval, MD

  • Surgery Physician
  • Cut Off, LA
National Provider Identifier
1477521763
Registry record updated Aug 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
012312 Issued in LA
Practice address
144 W 134TH St
Cut Off, LA 70345-4155
Phone
(985) 632-6233
Fax
(985) 632-7526
NPI assigned
Mar 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 012312 LA Primary

Addresses

Primary practice location

144 W 134TH St
Cut Off, LA 70345-4155

Mailing address

144 W 134TH St
Cut Off, LA 70345-4155
Phone (985) 632-6233

Other identifiers 1

IdentifierTypeStateIssuer
1195880MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
012312LAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lafourche Parish Hospital Service District No. 1 Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440115200000",
    "number": "1477521763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 W 134TH ST",
            "city": "CUT OFF",
            "state": "LA",
            "postal_code": "703454155",
            "telephone_number": "985-632-6233",
            "fax_number": "985-632-7526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 W 134TH ST",
            "city": "CUT OFF",
            "state": "LA",
            "postal_code": "703454155",
            "telephone_number": "985-632-6233",
            "fax_number": "985-632-7526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNEVAL",
        "first_name": "MONTE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2015-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "012312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1195880",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cut Off, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.