Individual provider Active NPI

Eileen A Bonomi

  • Physical Therapist
  • Manorville, NY
National Provider Identifier
1770757114
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
009601-1 Issued in NY
Practice address
5 Tee View CT
Manorville, NY 11949-2939
Phone
(631) 874-3032
Fax
(631) 874-4105
NPI assigned
Apr 16, 2008
Last updated
Mar 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 009601-1 NY Primary

Addresses

Primary practice location

5 Tee View CT
Manorville, NY 11949-2939

Mailing address

11 Evon LN
Saint James, NY 11780-2512
Phone (631) 560-8692

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080716000317 NY Practitioner - Physical Therapist in Private Practice 2163595638 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
We Care Physical Therapy, P.C.Group PAC ID 4587554688, 5 clinicians

Practice addresses (Care Compare)

5 Tee View CT
Manorville, NY 11949-2939
Phone (631) 874-0962

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009601-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
We Care Physical Therapy, P.C. Physical Therapist CurrentSince Feb 5, 2008 Accepting new patients
Link Home Therapy Services of Ny-PT OT SLP PLLC CurrentSince Mar 2, 2019 Accepting new patients

Locations

180 Sylvan Ave
Ste 4
Englewood Cliffs, NJ 07632
Phone (347) 841-8943

108 S Franklin Ave
Ste 10
Valley Stream, NY 11580
Phone (646) 745-0854

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1770757114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 EVON LN",
            "city": "SAINT JAMES",
            "state": "NY",
            "postal_code": "117802512",
            "telephone_number": "631-560-8692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 TEE VIEW CT",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119492939",
            "telephone_number": "631-874-3032",
            "fax_number": "631-874-4105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONOMI",
        "first_name": "EILEEN",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-16",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "009601-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manorville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.