Active NPI
Bonnie Jean Greene, RPA-C
- Physician Assistant
- West Islip, NY
National Provider Identifier
1649445941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 009557-1
- Practice address
- 340 Montauk Hwy
West Islip, NY 11795-4437 - Phone
- (631) 422-9530
- NPI assigned
- Apr 28, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 009557-1 | NY | Primary |
Addresses
Primary practice location
340 Montauk Hwy
West Islip, NY 11795-4437
Mailing address
340 Montauk Hwy
West Islip, NY 11795-4437
Phone (631) 422-9530
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009557-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446681600000",
"number": "1649445941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "340 MONTAUK HWY",
"city": "WEST ISLIP",
"state": "NY",
"postal_code": "117954437",
"telephone_number": "631-422-9530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 MONTAUK HWY",
"city": "WEST ISLIP",
"state": "NY",
"postal_code": "117954437",
"telephone_number": "631-422-9530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENE",
"first_name": "BONNIE",
"middle_name": "JEAN",
"name_prefix": "Ms.",
"credential": "RPA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-28",
"last_updated": "2015-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "009557-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Islip, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.