Patricia A Bona-Kustra, D.C.

Individual provider Active NPI Orthopedic Chiropractor · Blue Bell, PA

NPI 1851346290 · NPPES record last updated Sep 23, 2011

Key facts

NPI
1851346290
Entity type
Individual (NPI type 1)
Primary specialty
Orthopedic Chiropractor 111NX0800X
License
DC003461L (PA)
Practice address
914 Skippack Pike
Blue Bell, PA 19422-1535
Phone
(215) 540-0776
NPI assigned
May 24, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare Care Compare profile

Specialty
Chiropractic
Education
Logan College of Chiropractic, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Broad Axe Chiropractic Center (2 clinicians)

Practice addresses (Care Compare)

914 Skippack Pike
Blue Bell, PA 19422-1535
Phone (215) 540-0776

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20120103000349 PA Practitioner - Chiropractic 4688840242 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Broad Axe Chiropractic Center Current
since Nov 2, 2011
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Chiropractor 111NX0800X DC003461L PA Yes

Addresses

Primary practice location

914 Skippack Pike
Blue Bell, PA 19422-1535

Mailing address

914 Skippack Pike
Blue Bell, PA 19422-1535
Phone (215) 540-0776

Other identifiers

IdentifierTypeStateIssuer
000001241670 02OtherPAUNITED HEALTHCARE
001384519OtherPAHIGHMARK BLUE SHIELD
0847332OtherPAAETNA
0109289000OtherPABC PERSONAL CHOICE

Other providers in Blue Bell, PA

All providers in Blue Bell, PA · Orthopedic Chiropractor in Pennsylvania

Sources for this page

Verify at the official NPI Registry.