Individual provider Active NPI

Bonald Theus Phillips, M.D.

  • Obstetrics & Gynecology Physician
  • Brooklyn, NY
National Provider Identifier
1699086421
Registry record updated Jun 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
237115 Issued in NY
Practice address
335 Central Ave
Brooklyn, NY 11221-4501
Phone
(718) 443-9300
NPI assigned
Jun 25, 2010
Last updated
Jun 25, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 237115 NY Primary

Addresses

Primary practice location

335 Central Ave
Brooklyn, NY 11221-4501

Mailing address

760 Broadway
Brooklyn, NY 11206-5317
Phone (718) 963-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20101227000648 NY Practitioner - Obstetrics/Gynecology 2466640099 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
New York Medical College, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TJH Medical Services PCGroup PAC ID 8527960533, 215 clinicians

Practice addresses (Care Compare)

120 46 Queens Blvd
Kew Gardens, NY 11415
Phone (718) 006-6708

2060 Utica Ave
Brooklyn, NY 11234-3216
Phone (718) 676-5312

89 -40
Jamaica, NY 11418-2832
Phone (718) 206-5200

8900 Van Wyck Expressway
Jamaica, NY 11418-2832

8900 Van Wyck Expy
Jamaica, NY 11418-2832

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.41 of 100Reported as group
Quality
64.77
Promoting interoperability
79
Improvement activities
40
Cost
70.76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
237115NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
TJH Medical Services, P.C. Obstetrics & Gynecology CurrentSince Apr 22, 2020 Accepting new patients
Jamaica Hospital CurrentSince Aug 4, 2019 Accepting new patients
Jamaica Hospital CurrentSince Aug 4, 2019 Accepting new patients
Jamaica Hospital Medical Center Past Accepting new patients

Locations

2060 Utica Ave
Brooklyn, NY 11234
Phone (718) 676-5309

3080 Atlantic Ave
Brooklyn, NY 11208
Phone (718) 647-0240

11940 Metropolitan Ave
Kew Gardens, NY 11415
Phone (718) 849-0839

80 Marcus Dr
Melville, NY 11747
Phone (631) 391-7889

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: bphillips563113@nychhc.direct-ci.com
  • Direct secure messaging: bphillips89363@direct.medisys.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 1

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": "1277424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277424000000",
    "number": "1699086421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 BROADWAY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112065317",
            "telephone_number": "718-963-8000",
            "fax_number": "718-963-8529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 CENTRAL AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112214501",
            "telephone_number": "718-443-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "BONALD",
        "middle_name": "THEUS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-25",
        "last_updated": "2010-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "237115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.