Charles A Bonerbo, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R-039863-1 Issued in NY

Practice address

168 W 86TH St
Suite 1 D
New York, NY 10024-4022

Phone

(917) 539-2032

NPI assigned

Jan 22, 2007

Last updated

Oct 22, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• New York Neuromodulation Medical PLLC

  • Psychiatry Physician
  • New York, NY
  • NPI 1558891135
  NPD (past)

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413936000000",
    "number": "1922152529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4315 WEBSTER AVE",
            "address_2": "APT 1F",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104702358",
            "telephone_number": "917-539-2032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 W 86TH ST",
            "address_2": "SUITE 1 D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100244022",
            "telephone_number": "917-539-2032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONERBO",
        "first_name": "CHARLES",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2014-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R-039863-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula Boned Fustel, MD
• Samantha Nicole Bonello
• Sophia Bonenfant
• Alexis Boneparth, M.D.
• Pamela M Boneparth, LCSW
• Jennifer Bonesteel
• Jessica Bonet, MS
• Jessica Maria Bonet
• Juliana Elizabeth Boneta, O.D.
• Annette Bonets, MPA; CASAC II

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.