NPIMap

Individual provider Active NPI

Rosario P Bonafede, MD

  • Rheumatology Physician
  • Portland, OR
National Provider Identifier
1730125667
Registry record updated Oct 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
MD16090 Issued in OR
Practice address
5050 NE Hoyt St
Ste 155
Portland, OR 97213-2956
Phone
(503) 215-6819
Fax
(503) 215-6492
NPI assigned
Jun 20, 2006
Last updated
Oct 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X MD16090 OR Primary

Addresses

Primary practice location

5050 NE Hoyt St
Ste 155
Portland, OR 97213-2956

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Other identifiers 2

IdentifierTypeStateIssuer
054416MedicaidOR
P00745121OtherRR MEDICARE

Other names 1

  • R Peter Bonafede Other name

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address rbonafede117572@oc.providencedirect.org
Direct Messaging Address rbonafede117572@oc.providencedirect.org
Direct Messaging Address rbonafede117572@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090821000570 OR Practitioner - Rheumatology 7214081462 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 1974
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 3158
Portland, OR 97208-3158

PO Box
Suite 3395
Portland, OR 97208-3395

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince Sep 1, 2023 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jul 1, 2009 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 1, 2014 Accepting new patients
Providence Health & Services Oregon CurrentSince Jul 1, 2009 Accepting new patients
Providence Health & Services - Oregon CurrentSince Sep 1, 2023 Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

200 S Hazel Dell Way
Ste 210
Canby, OR 97013
Phone (503) 263-9550

9290 SE Sunnybrook Blvd
Ste 210
Clackamas, OR 97015
Phone (503) 216-7960

1500 Division St
Oregon City, OR 97045
Phone (503) 646-1631

1510 Division St
Ste 170
Oregon City, OR 97045
Phone (503) 215-6819

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

5050 NE Hoyt St
Ste 155
Portland, OR 97213
Phone (503) 215-6819

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

Organizations & group practices 9

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 4

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1730125667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494",
            "fax_number": "503-215-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 NE HOYT ST",
            "address_2": "STE 155",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132956",
            "telephone_number": "503-215-6819",
            "fax_number": "503-215-6492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONAFEDE",
        "first_name": "ROSARIO",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "OR",
            "license": "MD16090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "054416",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00745121",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rbonafede117572@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "5050 NE Hoyt St",
            "address_2": "Ste 155",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132956",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rbonafede117572@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "4805 NE Glisan St",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132933",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rbonafede117572@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1500 Division St",
            "city": "Oregon City",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970451527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "R PETER",
            "last_name": "BONAFEDE",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.