NPIMap

Individual provider Active NPI

Sara Lynn Bonanini, MSN, APRN, NP-C

  • Family Nurse Practitioner
  • Crow Agency, MT
National Provider Identifier
1801275037
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
174463 Issued in MT
Practice address
10110 South 7650 East
Crow Agency, MT 59022
Phone
(406) 638-3424
NPI assigned
May 20, 2015
Last updated
May 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 174463 MT Primary
Registered Nurse 163W00000X 44821 MT

Addresses

Primary practice location

10110 South 7650 East
Crow Agency, MT 59022

Mailing address

10110 South 7650 East
Crow Agency, MT 59022
Phone (406) 638-3424

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL sara.bonanini@ihs.gov Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220331002604 TX Practitioner - Nurse Practitioner 1759777634 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Drexel University College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10110 S 7650
Crow Agency, MT 59022-0009
Phone (406) 638-4616

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
44821MTMDRegistered Nurse
174463MTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
US Health Dept of Health & Human Services CurrentSince Dec 28, 2024 Accepting new patients
US Health Dept of Health & Human Services Current Accepting new patients

Locations

669 Agency Main St
Harlem, MT 59526
Phone (406) 353-3100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1432080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1801275037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10110 SOUTH 7650 EAST",
            "city": "CROW AGENCY",
            "state": "MT",
            "postal_code": "59022",
            "telephone_number": "406-638-3424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10110 SOUTH 7650 EAST",
            "city": "CROW AGENCY",
            "state": "MT",
            "postal_code": "59022",
            "telephone_number": "406-638-3424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONANINI",
        "first_name": "SARA",
        "middle_name": "LYNN",
        "credential": "MSN, APRN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-20",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "174463",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MT",
            "license": "44821",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "sara.bonanini@ihs.gov",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10110 South 7650 East",
            "city": "Crow Agency",
            "state": "MT",
            "country_code": "US",
            "postal_code": "59022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crow Agency, MT

Sources for this page

Verify at the official NPI Registry.