George J Bonnevie III, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

217144 Issued in MA

Practice address

680 Centre St
Radiology Department
Brockton, MA 02302-3308

Phone

(508) 941-7150

Fax

(508) 941-6104

NPI assigned

May 18, 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

Diagnostic Radiology

Education

Boston University School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Signature Healthcare Medical Group IncGroup PAC ID 7719876267, 250 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Signature Healthcare Brockton Hospital Hospital, Brockton, MA, CCN 220052

Merit-based Incentive Payment System (MIPS)

Final score

88.83 of 100Reported as group

Quality

70.13

Promoting interoperability

100

Improvement activities

40

Cost

75.97

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: george.bonnevie@direct.signature.masshiway.net

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.

• Signature Healthcare Medical Group Inc

  • Internal Medicine Physician
  • Brockton, MA
  • NPI 1508804949

  MA

  Medicare reassignment Care Compare group NPD
• Shields Signature Imaging, LLC

  • Mobile Radiology Clinic/Center
  • Brockton, MA
  • NPI 1417320912
  NPD

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

• Brockton Hospital, Inc.

  • General Acute Care Hospital
  • Brockton, MA
  • NPI 1063431286

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1790738250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 CENTRE ST",
            "address_2": "RADIOLOGY DEPARTMENT",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023023308",
            "telephone_number": "508-941-7150",
            "fax_number": "508-941-6104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 CENTRE ST",
            "address_2": "RADIOLOGY DEPARTMENT",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023023308",
            "telephone_number": "508-941-7150",
            "fax_number": "508-941-6104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNEVIE",
        "first_name": "GEORGE",
        "middle_name": "J",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "217144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2005883",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Boisvert, LCSW
• Amy Karen Bolinder, LICSW
• Nathalie Alexandra Bonheur
• Pamela Sarah Bonin
• Nicole Bonnet
• Stephen Charles Bonsignore-Berry, PSY.D.
• Maya Curwina Bootman
• Isabela Borelli-Gomes
• Maria A Borey, MSW
• Amanda Borges, COTA/L

• All providers in Brockton, MA
• Diagnostic Radiology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.