Omega M Bonnell-Bradley, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

382 Issued in MA

Practice address

230 Worcester St
Wellesley, MA 02481-5420

Phone

(781) 431-5200

Fax

(781) 431-5298

NPI assigned

Apr 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1780647545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 CANAL ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021486701",
            "telephone_number": "781-338-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 WORCESTER ST",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024815420",
            "telephone_number": "781-431-5200",
            "fax_number": "781-431-5298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNELL-BRADLEY",
        "first_name": "OMEGA",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-11",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "382",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "382",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth M Bobby, N.P.
• Laura Teresa Boitano, MD
• Anela Bolfek, M.D.
• Debora Bolter, PH.D.
• Dean Bonneau, DPT
• John Bordiuk, MD
• Mitchell Robert Bornstein, PHD.
• Boston Breast Diagnostic Center LLC
• Boston Eyelid Surgery LLC
• Boston Hernia & Pilonidal Center PLLC

• Physician Assistant in Wellesley, MA
• Providers in Wellesley, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; 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.