Wayne Bonkowski, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

20962 Issued in MA

Practice address

4110 Mystic Valley Pkwy Ste 12
Medford, MA 02155

Phone

(781) 960-6030

NPI assigned

Feb 18, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Performance Rehabilitation of Western New England LLCGroup PAC ID 7911979950, 201 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

85.19 of 100Reported as group

Quality

86.04

Improvement activities

40

Cost

76.23

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Performance Rehabilitation of Western New England LLC

  • Physical Therapist
  • West Springfield, MA
  • NPI 1710919063
  Medicare reassignment Care Compare group NPD
• Performance Rehabilitation of Western New England LLC

  • Durable Medical Equipment & Medical Supplies
  • Wilbraham, MA
  • NPI 1376140566

  Physical Therapist

  NPD

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

{
    "created_epoch": "1392681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529884800000",
    "number": "1871917492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223",
            "fax_number": "630-759-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 MYSTIC VALLEY PKWY STE 12",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "02155",
            "telephone_number": "781-960-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONKOWSKI",
        "first_name": "WAYNE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-18",
        "last_updated": "2018-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "20962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Betty Jo Bolin, MSW
• Jennifer L. Bonczek, RD
• Christine M Bond-Eaves, MA CCCA A
• Abigail Bond, MHC
• Sara Ines Bonilla, LMHC, CCM
• Sharon Lee Bonnellbradley, LICSW
• Borrelli Counseling LLC
• Boston Behavioral Health Associates Inc
• Boston Center for Facial Aesthetics
• Boston Laser Eye Institute- Winchester LLC

• Physical Therapist in Medford, MA
• Providers in Medford, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.