Daniel Charles Bonanno, DPT
Individual provider Active NPI Physical Medicine & Rehabilitation Physician · Dracut, MA
NPI 1912782004 · NPPES record last updated Aug 28, 2023
Key facts
- NPI
- 1912782004
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Medicine & Rehabilitation Physician 208100000X
- License
- 27062 (MA)
- Practice address
- 1595 Bridge St
Dracut, MA 01826-2696 - Phone
- (978) 735-4479
- Fax
- (978) 735-4490
- NPI assigned
- Aug 28, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Scaccia Physical Therapy and Sports Conditioning, LLC
Practice addresses (Care Compare)
1595 Bridge St
Unit 5
Dracut, MA 01826-2696
Phone (978) 735-4479
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240520000379 | MA | Practitioner - Physical Therapist in Private Practice | 8426499690 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27062 | MA | MD | Physical Medicine & Rehabilitation Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Scaccia Physical Therapy & Sports Conditioning, LLC | Current |
Accepting new patients |
Locations
32 Indian Rock Rd
Unit 5
Windham, NH 03087
Phone (603) 890-8541
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 27062 | MA | Yes |
Addresses
Primary practice location
1595 Bridge St
Dracut, MA 01826-2696
Mailing address
1595 Bridge St
Dracut, MA 01826-2696
Phone (978) 735-4490
Other providers in Dracut, MA
- Alexis Louise Beauchesne
- Becomingyou Counseling Services
- Christopher John Berard
- Hayley Blatus
- Casey Boisvert
- Sambath Bou
- Rachel Logan Boumil
- Bridgewood Family Chiropractic, PC
- Jaelithe Brodeur
- Leigh E. Bryant
All providers in Dracut, MA · Physical Medicine & Rehabilitation Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 28, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.