Active NPI
Holly Ann Bonasera, MPT
- Physical Therapist
- Omaha, NE
National Provider Identifier
1780742866
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2929
- Practice address
- 1219 Leavenworth St
Omaha, NE 68102-3214 - Phone
- (415) 518-5986
- NPI assigned
- Dec 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2929 | NE | Primary |
Addresses
Primary practice location
1219 Leavenworth St
Omaha, NE 68102-3214
Mailing address
11600 Old Mill Dr
Blair, NE 68008-6615
Phone (415) 518-5986
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20962 | CA | MD | Professional Counselor |
| 2929 | NE | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Downtown Therapy Inc. | Current | Accepting new patients |
Locations
1219 Leavenworth St
Omaha, NE 68102
Phone (402) 699-3718
Organizations & group practices 1
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Omaha, NE
- NPI 1720311574
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447891200000",
"number": "1780742866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11600 OLD MILL DR",
"city": "BLAIR",
"state": "NE",
"postal_code": "680086615",
"telephone_number": "415-518-5986"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1219 LEAVENWORTH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681023214",
"telephone_number": "415-518-5986"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONASERA",
"first_name": "HOLLY",
"middle_name": "ANN",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-04",
"last_updated": "2015-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NE",
"license": "2929",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.