Raphael Edward Bonita, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

MD428378 Issued in PA

Practice address

925 Chestnut St
Mezzanine Level
Philadelphia, PA 19107-4216

Phone

(215) 955-5050

Fax

(215) 955-1174

NPI assigned

Oct 11, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Cardiovascular Disease (Cardiology)

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Einstein Practice Plan IncGroup PAC ID 2769395896, 774 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jefferson Einstein Philadelphia Hospital Hospital, Philadelphia, PA, CCN 390142

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Einstein Practice Plan Inc

  • Psychiatry Physician
  • Philadelphia, PA
  • NPI 1760434468

  PA

  Medicare reassignment Care Compare group NPD
• Einstein Practice Plan Inc

  • Certified Registered Nurse Anesthetist
  • Philadelphia, PA
  • NPI 1457047433
  NPD
• Einstein Practice Plan Inc

  • Cardiovascular Disease Physician
  • Philadelphia, PA
  • NPI 1598723165

  Cardiovascular Disease

  NPD
• Albert Einstein Medical Center

  • General Acute Care Hospital
  • Phila, PA
  • NPI 1902805245
  NPD (past)

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

• Einstein Hospital

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1366653818

  Hospital

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1790973147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK ROAD",
            "address_2": "KORMAN, SUITE 202",
            "city": "PHIALDELPHIA",
            "state": "PA",
            "postal_code": "191413018",
            "telephone_number": "215-456-2630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 CHESTNUT ST",
            "address_2": "MEZZANINE LEVEL",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074216",
            "telephone_number": "215-955-5050",
            "fax_number": "215-955-1174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONITA",
        "first_name": "RAPHAEL",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-11",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD428378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1024344320001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0225088",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles Bongiorno, MD
• Diana Marie Bongiorno, MD
• Valerie Bonica, DO
• Brandy Bonilla, PCB CERTIFIED DOULA
• Edickson Bonilla, MA
• Jayne Lindholm Bonko, PHARMD, MBA
• Susannah Bonn, MFT
• Tamar Bonne-Annee, CCC-SLP
• Alexander Remy Bonnel, M.D.
• Bruce Bonnell, MD

• Cardiovascular Disease Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Cardiovascular Disease Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; 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.