Baokim Nguyen Bonelli, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA01411 Issued in RI

Practice address

17 Wells St Ste 203
Westerly, RI 02891-2923

Phone

(401) 348-0660

Fax

(401) 348-3090

NPI assigned

Sep 28, 2013

Sex

Female

Sole proprietor

No

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.

• Brown Dermatology, Inc.

  • Dermatology Physician
  • Providence, RI
  • NPI 1730538026

  RI

  Medicare reassignment Care Compare group
• Lifespan Physician Group, Inc.

  • General Practice Physician
  • Providence, RI
  • NPI 1407116643

  RI

  Medicare reassignment Care Compare group
• Bobby Buka, M.D., P.C.

  • Dermatology Physician
  • New York, NY
  • NPI 1134349954

  NY

  Medicare reassignment NPD
• Lifespan Physician Group, Inc.

  • Anesthesiology Physician
  • Providence, RI
  • NPI 1053782466
  Care Compare group
• Lifespan Physician Group, Inc.

  • Urgent Care Clinic/Center
  • Warwick, RI
  • NPI 1285191163
  Care Compare group
• Lifespan Physician Group, Inc.

  • Psychiatry Physician
  • Providence, RI
  • NPI 1548506793
  Care Compare group
• John R. West MD Inc

  • MOHS-Micrographic Surgery Physician
  • Mystic, CT
  • NPI 1376575324
  Care Compare group
• Lifespan Physician Group Inc

  • Dermatology Physician
  • Providence, RI
  • NPI 1578424602
  NPD
• Lifespan Physician Group, Inc.

  • Emergency Medicine Physician
  • Providence, RI
  • NPI 1568325678

  Physician Assistant

  NPD
• Derm Specs of PA PLLC

  • Dermatology Physician
  • Philadelphia, PA
  • NPI 1528823507
  NPD (past)

Specialty

Physician Assistant

Education

State University of New York at Stony Brook, School of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brown Dermatology Inc 28 clinicians

John R. West MD Inc 4 clinicians

Lifespan Physician Group Inc 1,151 clinicians

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in NY, RI, CT3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BFCDAA

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 17, 2025.

{
    "created_epoch": "1380326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1841627353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 LA SALLE SQ",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029031814",
            "telephone_number": "401-444-6779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 WELLS ST STE 203",
            "city": "WESTERLY",
            "state": "RI",
            "postal_code": "028912923",
            "telephone_number": "401-348-0660",
            "fax_number": "401-348-3090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "65 Village Square Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "South Kingstown",
            "state": "RI",
            "postal_code": "028792569",
            "country_code": "US",
            "telephone_number": "401-444-7959",
            "fax_number": "401-515-7910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONELLI",
        "first_name": "BAOKIM",
        "middle_name": "NGUYEN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-28",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA01411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841627353",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jamie Blalock, LMFT
• Shana Lee Bloom, LMHC
• Alyssa Kay Boardman, LMHC
• Alexis Anne Bobek, APRN
• Peter E. Bolton, M.D.
• Caitlin Elizabeth Bouchard
• Jodie Elizabeth Boumenot
• Marcia Bourque-Moreno, CRNA
• Melanie Anne Bowdy, APRN, FNP-C
• Elizabeth Boyle, PT, DPT

• All providers in Westerly, RI
• Physician Assistant in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2025; 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.