Boniface Orthopaedics, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

0170960001 Issued in OH

Legal business name

BONIFACE ORTHOPAEDICS, INC.

Practice address

835 McKay CT
Suite 100
Youngstown, OH 44512-5786

Phone

(330) 758-4399

Fax

(330) 799-8995

NPI assigned

Oct 25, 2006

Organization subpart

No

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

Authorized official

Name

Raymond John Boniface, M.D.

Title

President

Phone

(330) 758-4399

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962587543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 MCKAY CT",
            "address_2": "SUITE 100",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445125786",
            "telephone_number": "330-758-4399",
            "fax_number": "330-799-8995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 MCKAY CT",
            "address_2": "SUITE 100",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445125786",
            "telephone_number": "330-758-4399",
            "fax_number": "330-799-8995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONIFACE ORTHOPAEDICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BONIFACE",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-758-4399",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OH",
            "license": "0170960001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0701173",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0701182",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0929142",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theresa G Bohr, LISW
• Alycia Marshell Bolds
• Brant Andrew Bolen, CDCA
• Todd Bonar
• Jessica Bonetti
• Boniface Surgical Associates, LLC
• Nicholas Chapman Boniface, MD, MPH
• Raymond John Boniface, M.D.
• Mali Bonilla, LPN
• Morgan Brittany Bookman, DO

• All providers in Youngstown, OH
• Durable Medical Equipment & Medical Supplies in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.