John Michael Bonina, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1032265 Issued in MA

Practice address

21 Edlin St
Worcester, MA 01603-1944

Phone

(508) 757-9566

NPI assigned

Aug 15, 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

Other names 1

• Mr. Jack Bonina Other name

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730192121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 EDLIN ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016031944",
            "telephone_number": "508-757-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 EDLIN ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016031944",
            "telephone_number": "508-757-9566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONINA",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1032265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACK",
            "last_name": "BONINA",
            "prefix": "MR.",
            "credential": "LICSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Samantha A Bond, NP
• Johan Hendrik Leonard Boneschansker, MD
• Emily Linda Bonfiglio
• Avianna Bongovio
• Deborah Jo Bonin, PTA
• Callie Michelle Bonneau
• Jean-Paul Bonneau, CRNA
• Stephanie Bonneau, CRNA
• Alice R Bonner, GNP
• Lauren Elizabeth Bonnette, APRN

• Clinical Social Worker in Worcester, MA
• Providers in Worcester, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.