Individual provider Active NPI

Alexis Bonner, FNP-BC

  • Family Nurse Practitioner
  • Flushing, NY
National Provider Identifier
1710312111
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F346414 Issued in NY
Practice address
15515 71St Ave
2A
Flushing, NY 11367-2216
Phone
(347) 439-1642
NPI assigned
Sep 5, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X F346414 NY
Family Nurse Practitioner 363LF0000X F346414 NY Primary

Addresses

Primary practice location

15515 71St Ave
2A
Flushing, NY 11367-2216

Mailing address

15515 71St Ave
2A
Flushing, NY 11367-2216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231229002243 CT Practitioner - Nurse Practitioner 1850741026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians for Women'S Health, LLCGroup PAC ID 3274430665, 319 clinicians

Practice addresses (Care Compare)

103 Newtown Rd
Candlewood Center for Womens Health
Danbury, CT 06810-4195
Phone (203) 730-8789

Merit-based Incentive Payment System (MIPS)

Final score
89.08 of 100Reported as group
Quality
85.82
Promoting interoperability
100
Improvement activities
40
Cost
77.8

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F346414NYMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians for Women'S Health LLC Family CurrentSince Jun 17, 2024 Accepting new patients

Locations

103 Newtown Rd
Danbury, CT 06810
Phone (203) 730-8789

175 Capital Blvd
Fl 3
Rocky Hill, CT 06067

5520 Park Ave
Ste WP2700
Trumbull, CT 06611
Phone (203) 374-1018

Interoperability endpoints

  • Direct secure messaging: alexis.bonner.1@10170.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1378339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1710312111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15515 71ST AVE",
            "address_2": "2A",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113672216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15515 71ST AVE",
            "address_2": "2A",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113672216",
            "telephone_number": "347-439-1642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNER",
        "first_name": "ALEXIS",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-05",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "NY",
            "license": "F346414",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F346414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.