Individual provider Active NPI

Jason Andrew Bonomo, MD, PHD

  • Cardiovascular Disease Physician
  • Fairfax, VA
National Provider Identifier
1649628306
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
0101274803 Issued in VA
Practice address
8081 Innovation Park Dr Ste 700
Fairfax, VA 22031-4867
Phone
(571) 472-2900
NPI assigned
Jun 2, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101274803 VA
Hospitalist Physician 208M00000X 036.149207 IL
Cardiovascular Disease Physician 207RC0000X 0101274803 VA Primary

Addresses

Primary practice location

8081 Innovation Park Dr Ste 700
Fairfax, VA 22031-4867

Mailing address

PO Box 37174
Baltimore, MD 21297-3174
Phone (571) 423-5699

Other practice location 1

251 E Huron St
Chicago, IL 60611-2908
Phone (312) 695-0070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221114000431 DC Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 5698069151 Reassigns benefits to 1 organization
I20240618001183 VA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 5698069151 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Wake Forest University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

21785 Filigree CT
Ashburn, VA 20147-6214

3300 Gallows Rd
Falls Church, VA 22042-3307

3580 Joseph Siewick Dr
Fairfax, VA 22033-1717
Phone (703) 852-7760

3580 Joseph Siewick Dr
Fairfax, VA 22033-1764

3600 Joseph Siewick Dr
Fairfax, VA 22033-1709
Phone (703) 391-3600

3833 Fairfax Dr
Arlington, VA 22203-1773

4320 Seminary Rd
Alexandria, VA 22304-1535

44045 Rivderside Pkwy
Leesburg, VA 20176-5101

7619 Little River Tpke
Suite 1000
Annandale, VA 22003-2629
Phone (703) 256-5680

8081 Innovation Park Dr
Fairfax, VA 22031-4867

8140 Ashton Ave
Suite 125
Manassas, VA 20109-5700
Phone (703) 280-5858

8221 Willow Oaks Corporate Dr
Fairfax, VA 22031-4512
Phone (703) 237-3446

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.36 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
71.49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0101274803VAMDInternal Medicine Physician
036.149207ILMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Aug 29, 2022 Accepting new patients
Inova Health Care Services Internal Medicine CurrentSince May 6, 2024 Accepting new patients
Inova Health Care Services CurrentSince Aug 29, 2022 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

3833 Fairfax Dr
Ste 201
Arlington, VA 22203
Phone (703) 351-9424

8081 Innovation Park Dr
Ste 700
Fairfax, VA 22031
Phone (571) 472-2900

8081 Innovation Park Dr
#700
Fairfax, VA 22031
Phone (571) 472-2900

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

Interoperability endpoints

  • Direct secure messaging: jbonomo1091283@soc.inova.org

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

Hospital & facility affiliations 7

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": "1464825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1649628306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37174",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973174",
            "telephone_number": "571-423-5699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8081 INNOVATION PARK DR STE 700",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314867",
            "telephone_number": "571-472-2900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "251 E Huron St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112908",
            "country_code": "US",
            "telephone_number": "312-695-0070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONOMO",
        "first_name": "JASON",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-02",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101274803",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036.149207",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": "0101274803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.