Timothy D Bonack, PT DOMPCC

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

2373 Issued in CO

Practice address

6189 Lehman Dr Ste 202
Colorado Springs, CO 80918-5409

Phone

(719) 694-8342

Fax

(719) 694-8347

NPI assigned

Apr 5, 2006

Last updated

Oct 5, 2018By the provider in NPPES

Sex

Male

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 CO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Wisconsin School of Medicine, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Manual Edge Physical Therapy Specialists LLCGroup PAC ID 5597161125, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Manual Edge Physical Therapy Specialists LLC

  • Orthopedic Physical Therapist
  • Colorado Springs, CO
  • NPI 1609542109
  Medicare reassignment Care Compare group NPD
• Manual Edge Physical Therapy Specialists LLC

  • Physical Therapist
  • Monument, CO
  • NPI 1265258024
  NPD Authorized official
• Holtby & Bonack PTR

  dba Spineworks Physiotherapy LLC

  • Orthopedic Physical Therapist
  • Colorado Springs, CO
  • NPI 1790821403
  NPD (past) Authorized official
• Manual Edge Physiotherapy LLC

  • Orthopedic Physical Therapist
  • Colorado Springs, CO
  • NPI 1962632620
  Authorized official Same address or phone

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538697600000",
    "number": "1609838432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6189 LEHMAN DR STE 202",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809185409",
            "telephone_number": "719-694-8342",
            "fax_number": "719-694-8347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6189 LEHMAN DR STE 202",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809185409",
            "telephone_number": "719-694-8342",
            "fax_number": "719-694-8347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONACK",
        "first_name": "TIMOTHY",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "PT DOMPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2018-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CO",
            "license": "2373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheyenne Lynn Bombardier, MA
• Irene Bombria
• Geoffrey Bommelaere
• Christina Bonacic
• Jared Paul Bonack, MS, LAT, ATC
• Zoe Bonack, PSYD
• Andrea A Bonanno
• Leatrisha Bonati
• Michele Bonati
• Kelsey Bond

• Orthopedic Physical Therapist in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Orthopedic Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.