Individual provider Active NPI

Bosco Edric Noronha, MD

  • Otolaryngology Physician
  • Indiana, PA
National Provider Identifier
1790722171
Registry record updated May 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD072191L Issued in PA
Practice address
1265 Wayne Avenue
Suite 100
Indiana, PA 15701-3578
Phone
(724) 349-5440
Fax
(724) 349-7445
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD072191L PA Primary

Addresses

Primary practice location

1265 Wayne Avenue
Suite 100
Indiana, PA 15701-3578

Mailing address

1265 Wayne Ave
Suite 100
Indiana, PA 15701-3578
Phone (724) 349-5440

Other identifiers 1

IdentifierTypeStateIssuer
001836979MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070605000416 PA Practitioner - Otolaryngology 5496853079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bosco E Noronha MD,PCGroup PAC ID 5496035750, 2 clinicians

Practice addresses (Care Compare)

1265 Wayne Ave
Suite 100
Indiana, PA 15701-3578

1265 Wayne Avenue
Suite 100
Indiana, PA 15701-3578

Hospital & facility affiliations

  • Indiana Regional Medical Center Hospital, Indiana, PA, CCN 390173
  • Punxsutawney Area Hospital Hospital, Punxsutawney, PA, CCN 390199

Merit-based Incentive Payment System (MIPS)

Final score
83.62 of 100Reported as group
Quality
67.25
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD072191LPAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bosco E Noronha MD,PC Otolaryngology CurrentSince Oct 1, 2016 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

1265 Wayne Ave
Ste 100
Indiana, PA 15701
Phone (724) 349-5440

Interoperability endpoints

  • Direct secure messaging: drnoronhamd@noronhamd.medentdirect.com

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 and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1790722171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 WAYNE AVE",
            "address_2": "SUITE 100",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013578",
            "telephone_number": "724-349-5440",
            "fax_number": "724-349-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 WAYNE AVENUE",
            "address_2": "SUITE 100",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013578",
            "telephone_number": "724-349-5440",
            "fax_number": "724-349-7445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORONHA",
        "first_name": "BOSCO",
        "middle_name": "EDRIC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "MD072191L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001836979",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indiana, PA

Sources for this page

Verify at the official NPI Registry.