Rocco John Bonavita, L.A.C.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

004275-1 Issued in NY

Practice address

28 Jetmore PL
Massapequa, NY 11758-7812

Phone

(917) 723-8278

NPI assigned

Jan 27, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1264550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1811228000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 JETMORE PL",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117587812",
            "telephone_number": "917-723-8278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 JETMORE PL",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117587812",
            "telephone_number": "917-723-8278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONAVITA",
        "first_name": "ROCCO",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "L.A.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-27",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "00427501",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "004275-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Boening, OTR/L
• Maxine Ann Bogen, MA CCC-SLP
• Jamie Bogenshutz, LCSW, R, CASAC
• Louis Rigaud Bois, ANP
• Kathy Bonanno, DC
• Philip Anthony Bongiorno, OTR
• Carl Boris, D.O.
• Todd M Bornfriend, PT
• Stephen John Borrelli, PHARMD., RPH
• Monica Bottari, MSOT, OTR/L

• Acupuncturist in Massapequa, NY
• Providers in Massapequa, NY by specialty
• Acupuncturist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.