Elizabeth A. Bonner, M.S.,CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

0179791 Issued in NY

Practice address

49 Wireless Blvd
Ste 170
Hauppauge, NY 11788-3965

Phone

(631) 382-7311

Fax

(631) 382-7399

NPI assigned

Nov 21, 2008

Last updated

Nov 21, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optimum Therapeutics PT and OT PLLCGroup PAC ID 5991977712, 41 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Optimum Therapeutics PT & OT PLLC

  • Physical Therapist
  • Melville, NY
  • NPI 1972882322
  Medicare reassignment Care Compare group NPD
• Propel Physical Therapy PC

  • Physical Therapist
  • Greenvale, NY
  • NPI 1619519972
  NPD (past)

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

{
    "created_epoch": "1227225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227225600000",
    "number": "1669627378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 WIRELESS BLVD",
            "address_2": "STE 170",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117883965",
            "telephone_number": "631-382-7311",
            "fax_number": "631-382-7399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 WIRELESS BLVD",
            "address_2": "STE 170",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117883965",
            "telephone_number": "631-382-7311",
            "fax_number": "631-382-7399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNER",
        "first_name": "ELIZABETH",
        "middle_name": "A.",
        "name_prefix": "Mrs.",
        "credential": "M.S.,CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-21",
        "last_updated": "2008-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "0179791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Bogart, MD
• Oksana Boldyrev
• Francesca Bonfiglio
• Catherine Elizabeth Bongo-Liselli
• Paul Bonheim, M.D.
• Jillian Bonner, M. ED., BCBA
• Christian Borg, RPH
• Caitlin Marie Borriello, N.P
• Jamie Borsman
• Deborah Monte Boruff, PH.D.

• Speech-Language Pathologist in Hauppauge, NY
• Providers in Hauppauge, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.