Individual provider Active NPI

Bonnie J Floyd, PH.D.

  • Health Service Psychologist
  • Lombard, IL
National Provider Identifier
1780624890
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service PsychologistTaxonomy code 103TH0100X
Practice address
1920 S Highland Ave
Suite 300
Lombard, IL 60148-4988
Phone
(630) 792-1343
Fax
(630) 576-5553
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Psychologist 103TH0100X IL Primary

Addresses

Primary practice location

1920 S Highland Ave
Suite 300
Lombard, IL 60148-4988

Mailing address

1920 S Highland Ave
Suite 300
Lombard, IL 60148-4988
Phone (630) 792-1343

Other identifiers 1

IdentifierTypeStateIssuer
21623169OtherILBC/BS PROVIDER ID

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20181016003560 NY Practitioner - Clinical Psychologist 0345139317 Reassigns benefits to 2 organizations
Practice locations: Amherst, NY; Orchard Park, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Albert Einstein College of Medicine of Yeshiva University, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sailor Health Medical of New York PCGroup PAC ID 2567931306, 9 clinicians

Practice addresses (Care Compare)

173 Huguenot St
Suite 200
New Rochelle, NY 10801-7710
Phone (240) 200-0173

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071-006557ILMDHealth Service Psychologist
022734NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Knapp Street Psychiatry, PC CurrentSince Oct 26, 2018 Accepting new patients
Che Senior Psychological Services, PC CurrentSince Oct 26, 2018 Accepting new patients
Millennium Pain Center LLC PastSince Jan 1, 1990 Accepting new patients
Millennium Pain Center of Lake County PastSince Jan 1, 1990 Accepting new patients
Aspen Behavioral Care PastSince Jul 31, 2013 Accepting new patients

Locations

3512 Quentin Rd
Ste 110
Brooklyn, NY 11234
Phone (718) 854-8370

1915 Ocean Ave
Brooklyn, NY 11230
Phone (718) 258-7700

250 Beach 17th St
Far Rockaway, NY 11691
Phone (516) 670-0212

209 Beach 125th St
Rockaway Park, NY 11694
Phone (516) 721-7625

135 Vanderbilt Ave
Staten Island, NY 10304
Phone (718) 447-0101

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780624890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 S HIGHLAND AVE",
            "address_2": "SUITE 300",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484988",
            "telephone_number": "630-792-1343",
            "fax_number": "630-576-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 S HIGHLAND AVE",
            "address_2": "SUITE 300",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484988",
            "telephone_number": "630-792-1343",
            "fax_number": "630-576-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLOYD",
        "first_name": "BONNIE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PROVIDER ID",
            "identifier": "21623169",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lombard, IL

Sources for this page

Verify at the official NPI Registry.