Jessica Buonomo, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

029944 Issued in NY

Practice address

17 Jeanne Ave
Port Jefferson Station, NY 11776-1909

Phone

(516) 232-7798

NPI assigned

Aug 31, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1730809583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 JEANNE AVE",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761909",
            "telephone_number": "516-232-7798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 JEANNE AVE",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761909",
            "telephone_number": "516-232-7798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUONOMO",
        "first_name": "JESSICA",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-31",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "029944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "jbuonomolmt@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "17 Jeanne Ave",
            "city": "Port Jefferson Station",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117761909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rebecca Brown, RN
• Theresa Brunetto
• James Buchrieser
• Brenna Katherine Buckstein, MSPAS, PA-C
• Rose M Bukovsky, ANP
• Michael Angelo Buonomo I, MS.ED.,PH.D.
• Jennifer Burdish
• Fern M Burke, LPN
• William Burke, R.PH.
• Stephanie Bux, MA CCC-SLP

• Massage Therapist in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Massage Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.