Justin J Bonacci, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

017345-1 Issued in NY

Practice address

1636 Montauk Hwy
Ste 4
Mastic, NY 11950-3016

Phone

(631) 399-0007

Fax

(631) 399-2992

NPI assigned

Jan 13, 2006

Sex

Male

Sole proprietor

Yes

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

Physical Therapist in Private Practice

Education

Other, 1997

Medicare assignment

May accept Medicare assignment

Group practices

Spagnoli Physical Therapy PCGroup PAC ID 1254595200, 11 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.01 of 100Reported as individual

Quality

80

Improvement activities

40

Cost

86.69

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Spagnoli Physical Therapy, PC

  • Physical Therapist
  • Centereach, NY
  • NPI 1386624237

  NY, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Bienetre Medical PC

  • Physical Therapist
  • New York, NY
  • NPI 1568037257

  NY, Physical Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509408000000",
    "number": "1700865136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 QUINCY ST",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117763420",
            "telephone_number": "631-467-4235",
            "fax_number": "631-467-2655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1636 MONTAUK HWY",
            "address_2": "STE 4",
            "city": "MASTIC",
            "state": "NY",
            "postal_code": "119503016",
            "telephone_number": "631-399-0007",
            "fax_number": "631-399-2992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONACCI",
        "first_name": "JUSTIN",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2017-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "017345-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura A Beattie, RN
• Kasheka Sidoney Bell, LPN
• Lynne M Bell
• Savannah Berliner
• Renee Bishop, LPN
• Latisha Bond
• Tiffany Bravo, L.P.N
• Gina Brennin
• Kylasia Bullard
• Donna Marie Burns, BA, MALS

• All providers in Mastic, NY
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2017; 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.