Active NPI
Julie Mary Bondanza, PHD PSYCHOLOGIST
- Psychologist
- Takoma Park, MD
National Provider Identifier
1730383191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 09127
- Practice address
- 22 Manor Cir
104
Takoma Park, MD 20912-4552 - Phone
- (301) 891-2331
- Fax
- (301) 891-2331
- NPI assigned
- Jun 12, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 09127 | MD | Primary |
| Psychologist | 103T00000X | 014554 | NY |
Addresses
Primary practice location
22 Manor Cir
104
Takoma Park, MD 20912-4552
Mailing address
22 Manor Cir
104
Takoma Park, MD 20912-4552
Phone (301) 891-2331
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051121000961 | DC | Practitioner - Clinical Psychologist | 2769372705 | Practice locations: Takoma Park, MD |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
22 Manor Cir
Apt 104
Takoma Park, MD 20912-4552
Phone (917) 687-0351
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09127 | MD | MD | Occupational Therapist |
| 014554 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292976000000",
"number": "1730383191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 MANOR CIR",
"address_2": "104",
"city": "TAKOMA PARK",
"state": "MD",
"postal_code": "209124552",
"telephone_number": "301-891-2331",
"fax_number": "301-891-2331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 MANOR CIR",
"address_2": "104",
"city": "TAKOMA PARK",
"state": "MD",
"postal_code": "209124552",
"telephone_number": "301-891-2331",
"fax_number": "301-891-2331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONDANZA",
"first_name": "JULIE",
"middle_name": "MARY",
"name_prefix": "Dr.",
"credential": "PHD PSYCHOLOGIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-12",
"last_updated": "2010-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MD",
"license": "09127",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "014554",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Takoma Park, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2010; 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.