Jerrold Charles Bonn, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

006869E Issued in PA

Practice address

7900 Old York Rd
Suite 106 B
Elkins Park, PA 19027-2318

Phone

(215) 635-3300

Fax

(215) 635-2750

NPI assigned

Dec 2, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2019 through Jan 1, 2027

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": "1165017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780752048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 OLD YORK RD",
            "address_2": "SUITE 106 B",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190272318",
            "telephone_number": "215-635-3300",
            "fax_number": "215-635-2750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 OLD YORK RD",
            "address_2": "SUITE 106 B",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190272318",
            "telephone_number": "215-635-3300",
            "fax_number": "215-635-2750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONN",
        "first_name": "JERROLD",
        "middle_name": "CHARLES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "006869E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Bojman, MS,RD,LDN
• Marquita Janinne Bolden, MSW, LCSW
• Bon Vivant Safety Eyewear Company Inc
• Lindsay Marie Bondurant, PH.D., CCC-A
• Sanjeev Bongu, M.D.
• Robert Bonnem
• Lenore Borowski, LSW
• Stephanie Bosche, CRNP
• Martin A. Boxman, CRNA
• Sophia Anne Breslin, DMD

• Psychiatry Physician in Elkins Park, PA
• Providers in Elkins Park, PA by specialty
• Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.