Individual provider Active NPI

Bonnie Kane

  • Physician Assistant
  • Washington, DC
National Provider Identifier
1649656687
Registry record updated Mar 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA031160 Issued in DC
Practice address
110 Irving St NW
Washington, DC 20010-3017
Phone
(202) 877-6733
NPI assigned
Jul 31, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0005831 MD
Physician Assistant 363A00000X PA031160 DC Primary

Addresses

Primary practice location

110 Irving St NW
Washington, DC 20010-3017

Mailing address

1884 Columbia Rd NW Apt 700
Washington, DC 20009-5133
Phone (502) 741-6430

Other practice location 1

900 23rd St NW
Washington, DC 20037-2342
Phone (202) 715-4000

Other names 1

  • Bonnie Leksrisawat Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20151120000537 DC Practitioner - Physician Assistant 0446550602 Reassigns benefits to 5 organizations
I20191028002801 MD Practitioner - Physician Assistant 0446550602 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as group
Quality
80.29
Promoting interoperability
100
Improvement activities
40
Cost
75.48

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C0005831MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince May 1, 2025 Accepting new patients
Washington Hospital Center Corp CurrentSince Oct 3, 2015 Accepting new patients
Medstar Medical Group II LLC CurrentSince May 1, 2025 Accepting new patients
District Hospital Partners LP CurrentSince Jul 6, 2020 Accepting new patients
District Hospital Partners L P CurrentSince Jul 6, 2020 Accepting new patients
Washington Hospital Center Corp CurrentSince Oct 3, 2015 Accepting new patients
WHC Emerg Phys CurrentSince Jul 1, 2021 Accepting new patients
WHC Physician Group LLC CurrentSince Jul 1, 2021 Accepting new patients

Locations

110 Irving St NW
Rm BA94
Washington, DC 20010
Phone (202) 877-6429

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

900 23rd St NW
Washington, DC 20037
Phone (202) 715-4750

3001 S Hanover St
Brooklyn Park, MD 21225
Phone (410) 350-3200

1406 Crain Hwy S
Glen Burnie, MD 21061
Phone (410) 768-6440

25500 Point Lookout Rd
Leonardtown, MD 20650
Phone (301) 475-6106

11355 Pembrooke Sq
Ste 108
Waldorf, MD 20603
Phone (202) 877-6733

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1438300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1649656687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1884 COLUMBIA RD NW APT 700",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200095133",
            "telephone_number": "502-741-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 IRVING ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200103017",
            "telephone_number": "202-877-6733"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 23rd St NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200372342",
            "country_code": "US",
            "telephone_number": "202-715-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANE",
        "first_name": "BONNIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-31",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0005831",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DC",
            "license": "PA031160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BONNIE",
            "last_name": "LEKSRISAWAT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.