James Michael Bonanno, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

74689 Issued in MA

Practice address

142 Berkeley St
Boston, MA 02116-5100

Phone

(617) 267-0900

Fax

(617) 247-3460

NPI assigned

Jan 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1760461115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 BERKELEY ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021165100",
            "telephone_number": "617-267-0900",
            "fax_number": "617-247-3460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 BERKELEY ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021165100",
            "telephone_number": "617-267-0900",
            "fax_number": "617-247-3460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONANNO",
        "first_name": "JAMES",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "74689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OJ 11647",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sherwin William Bonab, BDS
• Natalie Bonacker, BA
• Marzieh Bonakdarhashemi, LMHC
• John Ross Bonanni, M.D.
• Andrea Bonanno, PT
• Candice Suzanne Bonarrigo
• Christine Elise Bonarrigo, PHARMD
• Hannah Bonbrest
• Gregory Aaron Bonci, M.D.
• Allison R Bond, MD

• Internal Medicine Physician in Boston, MA
• Providers in Boston, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.