Devin M Bonura, PA-C

Individual provider Active NPI Medical Physician Assistant · North Babylon, NY

NPI 1629356266 · NPPES record last updated Jun 15, 2022

Key facts

NPI
1629356266
Entity type
Individual (NPI type 1)
Primary specialty
Medical Physician Assistant 363AM0700X
License
014958 (NY)
Practice address
1231 Deer Park Ave
North Babylon, NY 11703-3104
Phone
(631) 667-0388
Fax
(631) 968-7705
NPI assigned
Aug 1, 2011
Sex
Male
Sole proprietor
No

Organizations & group practices 4

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.

Medicare Care Compare profile

Merit-based Incentive Payment System (MIPS)

Final score
92.32 of 100 (group)
Quality
73.65
Promoting interoperability
95
Improvement activities
40
Cost
71.58

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20150729007633 NY Practitioner - Physician Assistant 6305169707 Reassigns benefits to 3 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
014958NYMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Shahzad Iqbal Physician PLLC Past
since Jun 21, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 014958 NY Yes

Addresses

Primary practice location

1231 Deer Park Ave
North Babylon, NY 11703-3104

Mailing address

1231 Deer Park Ave
North Babylon, NY 11703-3104
Phone (631) 667-0388

Other identifiers

IdentifierTypeStateIssuer
4248266MedicaidNY

Other providers in North Babylon, NY

All providers in North Babylon, NY · Medical Physician Assistant in New York

Sources for this page

Verify at the official NPI Registry.