Individual provider Active NPI

Haidee Rae Ganz-Bonhurst, DPT, M.S.,A.T.,C

  • Physical Therapist
  • Smithtown, NY
National Provider Identifier
1922058981
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
010927-1 Issued in NY
Practice address
50 Route 111
Suite 103
Smithtown, NY 11787-3700
Phone
(631) 360-0723
Fax
(631) 360-2346
NPI assigned
May 11, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 010927-1 NY Primary

Addresses

Primary practice location

50 Route 111
Suite 103
Smithtown, NY 11787-3700

Mailing address

50 Route 111
Suite 103
Smithtown, NY 11787-3700
Phone (631) 360-0723

Other identifiers 9

IdentifierTypeStateIssuer
0510681OtherNYU.S. HEALTHCARE
34501OtherNYCIGNA-ORTHONET
AZ00431AOtherNYMDNY
129689POtherNYHIP
ANC1171OtherNYOXFORD
0003850OtherNYINDEPENDENT HEALTH
6601841OtherNYGHI
77273OtherNYVYTRA
970302OtherNYCIGNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120127000625 NY Practitioner - Physical Therapist in Private Practice 8628235918 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

62 Lake Ave S
Suite C
Nesconset, NY 11767-1094
Phone (347) 280-6548

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
010927-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
RB Physical and Occupational Therapy PLLC Physical Therapist CurrentSince Dec 4, 2023 Accepting new patients
James Pierre-Glaude Physical Therapy and Athletic Training SVCS, P.C. Physical Therapist CurrentSince Jan 2, 2025 Accepting new patients
Haidee Ganz-Bonhurst P.T., P.C. Past Accepting new patients

Locations

981 US Highway 22
Fl 2
Bridgewater, NJ 08807
Phone (908) 231-0511

4013 Avenue U
Brooklyn, NY 11234
Phone (718) 692-0949

2555 Hempstead Tpke
Ste 1
East Meadow, NY 11554
Phone (516) 418-2324

62 Lake Ave S
Ste C
Nesconset, NY 11767
Phone (347) 280-6548

231 Beach 116th St
Rockaway Park, NY 11694
Phone (718) 474-2224

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1922058981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 ROUTE 111",
            "address_2": "SUITE 103",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873700",
            "telephone_number": "631-360-0723",
            "fax_number": "631-360-2346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 ROUTE 111",
            "address_2": "SUITE 103",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873700",
            "telephone_number": "631-360-0723",
            "fax_number": "631-360-2346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANZ-BONHURST",
        "first_name": "HAIDEE",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "DPT, M.S.,A.T.,C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "010927-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U.S. HEALTHCARE",
            "identifier": "0510681",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA-ORTHONET",
            "identifier": "34501",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDNY",
            "identifier": "AZ00431A",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "129689P",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "ANC1171",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "0003850",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "6601841",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VYTRA",
            "identifier": "77273",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "970302",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.