Individual provider Active NPI

Bonnie Lo, DO

  • Internal Medicine Physician
  • Henderson, NV
National Provider Identifier
1679063952
Registry record updated Aug 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2861 Issued in NV
Practice address
10624 S Eastern Ave # a-955
Henderson, NV 89052-2982
Phone
(702) 407-7700
Fax
(702) 388-8431
NPI assigned
May 13, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X SL1338 NV
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 2861 NV Primary

Addresses

Primary practice location

10624 S Eastern Ave # a-955
Henderson, NV 89052-2982

Mailing address

10624 S Eastern Ave # a-955
Henderson, NV 89052-2982
Phone (702) 407-7700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210602003363 NV Practitioner - Internal Medicine 4789083213 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Touro Un Col of Osteopathic Medicine, Henderson, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Platinum Hospitalists LLPGroup PAC ID 7214076322, 197 clinicians

Practice addresses (Care Compare)

7495 W Azure Dr
Suite 209
Las Vegas, NV 89130-4440
Phone (702) 407-7700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
61.15 of 100Reported as group
Quality
36.67
Improvement activities
40
Cost
61.8

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2861NVMDDentist
SL1338NVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Platinum Hospitalists LLP Single Specialty CurrentSince Jul 1, 2021 Accepting new patients
Platinum Hospitalists LLP Internal Medicine CurrentSince Jul 1, 2021 Accepting new patients
Platinum Hospitalists, LLP Internal Medicine PastSince Aug 11, 2024 Accepting new patients
Spring Valley Medical Center Past Accepting new patients

Locations

10624 S Eastern Ave
Ste A995
Henderson, NV 89052

10624 S Eastern Ave
#A955
Henderson, NV 89052
Phone (702) 407-7700

7495 W Azure Dr
Ste 209
Las Vegas, NV 89130
Phone (702) 327-6653

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1526169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1679063952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10624 S EASTERN AVE # A-955",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522982",
            "telephone_number": "702-407-7700",
            "fax_number": "702-407-7016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10624 S EASTERN AVE # A-955",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522982",
            "telephone_number": "702-407-7700",
            "fax_number": "702-388-8431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LO",
        "first_name": "BONNIE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-13",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "SL1338",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "2861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.