Individual provider Active NPI

Samantha Louise Bono, PAC

  • Surgical Physician Assistant
  • Ocean, NJ
National Provider Identifier
1619646411
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
25MP00639500 Issued in NJ
Practice address
1200 Eagle Ave
Ocean, NJ 07712-7631
Phone
(732) 660-6200
NPI assigned
Sep 7, 2021
Last updated
Jul 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 25MP00639500 NJ Primary

Addresses

Primary practice location

1200 Eagle Ave
Ocean, NJ 07712-7631

Mailing address

17 Clover Hill LN
Colts Neck, NJ 07722-1004
Phone (908) 839-5638

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20210923001179 NJ Practitioner - Physician Assistant 1456758184 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1640 Route 88 W
Brick, NJ 08724-3068
Phone (732) 458-7866

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
72.19 of 100Reported as group
Quality
42.79
Promoting interoperability
95
Improvement activities
40
Cost
68.67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Seaview Orthopaedics & Medical Associates LLP CurrentSince Sep 15, 2021 Accepting new patients
Seaview Orthopaedics & Medical Associates LLP Single Specialty CurrentSince Sep 15, 2021 Accepting new patients

Locations

1640 Route 88 W
Brick, NJ 08724
Phone (732) 458-7866

1200 Eagle Ave
Ocean, NJ 07712

Organizations & group practices 2

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 6

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": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1619646411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 CLOVER HILL LN",
            "city": "COLTS NECK",
            "state": "NJ",
            "postal_code": "077221004",
            "telephone_number": "908-839-5638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 EAGLE AVE",
            "city": "OCEAN",
            "state": "NJ",
            "postal_code": "077127631",
            "telephone_number": "732-660-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONO",
        "first_name": "SAMANTHA",
        "middle_name": "LOUISE",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-07",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00639500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocean, NJ

Sources for this page

Verify at the official NPI Registry.