NPIMap

Organization Active NPI

Boniface Orthopaedics, Inc.

  • Specialist
  • Boardman, OH
National Provider Identifier
1669406740
Registry record updated Jan 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
OH56633 Issued in OH
Legal business name
BONIFACE ORTHOPAEDICS, INC.
Practice address
835 McKay CT
Suite 100
Boardman, OH 44512-5786
Phone
(330) 758-4399
Fax
(330) 758-8995
NPI assigned
Jul 11, 2006
Last updated
Jan 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2008

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

Authorized official

Name
Dr. Raymond John Boniface, M.D.
Title
President
Phone
(330) 758-4399

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X OH56633 OH Primary

Addresses

Primary practice location

835 McKay CT
Suite 100
Boardman, OH 44512-5786

Mailing address

835 McKay CT
Suite 100
Boardman, OH 44512-5786
Phone (330) 758-4399

Other identifiers 4

IdentifierTypeStateIssuer
0929142MedicaidOH
0701173MedicaidOH
0136801MedicaidOH
0701182MedicaidOH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201046400000",
    "number": "1669406740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 MCKAY CT",
            "address_2": "SUITE 100",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445125786",
            "telephone_number": "330-758-4399",
            "fax_number": "330-758-8995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 MCKAY CT",
            "address_2": "SUITE 100",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445125786",
            "telephone_number": "330-758-4399",
            "fax_number": "330-758-8995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONIFACE ORTHOPAEDICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2008-01-23",
        "status": "A",
        "authorized_official_last_name": "BONIFACE",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-758-4399",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OH",
            "license": "OH56633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0929142",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0701173",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0136801",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0701182",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.