NPIMap

Individual provider Active NPI

Kimberly Bonica, ACNPC-AG

  • Acute Care Nurse Practitioner
  • Hackensack, NJ
National Provider Identifier
1588349773
Registry record updated Jun 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
26NR15467900 Issued in NJ
Practice address
30 Prospect Ave
Hackensack, NJ 07601-1915
Phone
(551) 996-2000
NPI assigned
Jun 16, 2023
Last updated
Jun 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 26NR15467900 NJ Primary

Addresses

Primary practice location

30 Prospect Ave
Hackensack, NJ 07601-1915

Mailing address

15 Lundy Ter
Butler, NJ 07405-1958
Phone (973) 919-6887

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, FL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250602001911 NJ Practitioner - Nurse Practitioner 7810406824 Reassigns benefits to 4 organizations
I20251212002943 FL Practitioner - Nurse Practitioner 7810406824 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Daniel Funsch Jr MD PCGroup PAC ID 1951801836, 139 clinicians
Lumina Care Medical NJ LLCGroup PAC ID 6608305156, 60 clinicians

Practice addresses (Care Compare)

1507 S Tuttle Ave
Sarasota, FL 34239-2608
Phone (212) 734-6621

25 E Lindsley Rd
Cedar Grove, NJ 07009-1023
Phone (212) 734-6621

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NR15467900NJMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Rebman BH LLC CurrentSince Dec 25, 2025 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Mar 28, 2025 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Mar 28, 2025 Accepting new patients
Daniel Funsch Jr, M.D., P.C. CurrentSince Oct 9, 2025 Accepting new patients
Hackensack Meridian Health Medical Group - Primary Care PC CurrentSince Jul 28, 2025 Accepting new patients
Lumina Care Medical NJ LLC CurrentSince Sep 26, 2025 Accepting new patients
Meridian Medical Group - Specialty Care, PC Past Accepting new patients

Locations

1507 S Tuttle Ave
Sarasota, FL 34239
Phone (941) 366-0336

25 E Lindsley Rd
Cedar Grove, NJ 07009
Phone (201) 647-8035

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

300 Perrine Rd
Ste 324
Old Bridge, NJ 08857
Phone (732) 753-9890

55 Meadowlands Pkwy
Secaucus, NJ 07094
Phone (201) 325-6744

885 3rd Ave
Fl 28
New York, NY 10022
Phone (929) 650-3990

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD
  • FHIR API: https://mepic.hmhn.org/fhir/api/FHIR/R4/

Organizations & group practices 8

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 4

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": "1686873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1588349773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 LUNDY TER",
            "city": "BUTLER",
            "state": "NJ",
            "postal_code": "074051958",
            "telephone_number": "973-919-6887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011915",
            "telephone_number": "551-996-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONICA",
        "first_name": "KIMBERLY",
        "credential": "ACNPC-AG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-16",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NJ",
            "license": "26NR15467900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.