NPIMap

Individual provider Active NPI

Annmarie Elizabeth Bonetti, D.O.

  • Family Medicine Physician
  • Columbiana, OH
National Provider Identifier
1851390769
Registry record updated Jun 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34-00-8108 Issued in OH
Practice address
107 Royal Birkdale Dr
Suite a
Columbiana, OH 44408
Phone
(330) 482-9350
Fax
(330) 482-2336
NPI assigned
Jul 21, 2005
Last updated
Jun 4, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34-00-8108 OH Primary

Addresses

Primary practice location

107 Royal Birkdale Dr
Suite a
Columbiana, OH 44408

Mailing address

9471 Market St
Suite B
North Lima, OH 44452-8702
Phone (330) 729-2388

Other identifiers 1

IdentifierTypeStateIssuer
2450628MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20041012000774 OH Practitioner - Family Practice 0547220857 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Health Physicians Youngstown, LLCGroup PAC ID 9234318270, 116 clinicians
Mrs Physical TherapyGroup PAC ID 0042128407, 168 clinicians

Practice addresses (Care Compare)

107 Royal Birkdale Dr
Suite a
Columbiana, OH 44408-8493
Phone (330) 729-1934

4538 Peach St
Erie, PA 16509-1364
Phone (814) 864-6650

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Youngstown, LLC Family Medicine CurrentSince Aug 19, 2018 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 1, 2022 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 1, 2022 Accepting new patients
Mercy Health Physicians Youngstown LLC CurrentSince Aug 19, 2018 Accepting new patients

Locations

107 Royal Birkdale Dr
Ste A
Columbiana, OH 44408
Phone (330) 482-9350

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

132 N Market St
East Palestine, OH 44413
Phone (330) 337-3332

9471 Market St
Ste B
North Lima, OH 44452
Phone (330) 480-0937

564 E 2nd St
Salem, OH 44460
Phone (234) 567-8150

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

Interoperability endpoints

  • Direct secure messaging: abonetti254460@direct.bsmhealth.org

Organizations & group practices 5

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 7

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": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528070400000",
    "number": "1851390769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9471 MARKET ST",
            "address_2": "SUITE B",
            "city": "NORTH LIMA",
            "state": "OH",
            "postal_code": "444528702",
            "telephone_number": "330-729-2388",
            "fax_number": "330-629-6468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 ROYAL BIRKDALE DR",
            "address_2": "SUITE A",
            "city": "COLUMBIANA",
            "state": "OH",
            "postal_code": "44408",
            "telephone_number": "330-482-9350",
            "fax_number": "330-482-2336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONETTI",
        "first_name": "ANNMARIE",
        "middle_name": "ELIZABETH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-21",
        "last_updated": "2018-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34-00-8108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2450628",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbiana, OH

Sources for this page

Verify at the official NPI Registry.