Individual provider Active NPI

Edward Michael Buonadonna, D.C.

  • Chiropractor
  • Lake Park, FL
National Provider Identifier
1922138635
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0007117 Issued in FL
Practice address
1421 10TH St
Lake Park, FL 33403-2044
Phone
(561) 863-8898
Fax
(561) 863-8380
NPI assigned
Mar 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH0007117 FL Primary

Addresses

Primary practice location

1421 10TH St
Lake Park, FL 33403-2044

Mailing address

21 Balfour Rd W
Palm Beach Gardens, FL 33418-7090
Phone (561) 625-6412

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190920002512 FL Practitioner - Chiropractic 4082944897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1421 10TH St
Lake Park, FL 33403-2044
Phone (561) 863-8898

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH0007117FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Edward M. Bounadonna, D.C., P.a Chiropractor CurrentSince Jul 24, 2019 Accepting new patients

Locations

1421 10th St
Lake Park, FL 33403
Phone (561) 863-8898

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.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922138635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 BALFOUR RD W",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334187090",
            "telephone_number": "561-625-6412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 10TH ST",
            "city": "LAKE PARK",
            "state": "FL",
            "postal_code": "334032044",
            "telephone_number": "561-863-8898",
            "fax_number": "561-863-8380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUONADONNA",
        "first_name": "EDWARD",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0007117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.