Individual provider Active NPI

Candy Kyewaa Bonsu, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • New Brunswick, NJ
National Provider Identifier
1972763548
Registry record updated Jul 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
25MA09275900 Issued in NJ
Practice address
125 Patterson St
Rutgers University- Rwjms Dept of Anesthesia
New Brunswick, NJ 08901
Phone
(609) 955-4626
NPI assigned
Jun 16, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 25MA09275900 NJ Primary

Addresses

Primary practice location

125 Patterson St
Rutgers University- Rwjms Dept of Anesthesia
New Brunswick, NJ 08901

Mailing address

219 S. Washington Street
Dept of Anesth
Easton, MD 21601
Phone (609) 955-4626

Other names 1

  • Candy Kyewaa Anim Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150717000918 MD Practitioner - AnesthesiologyPractitioner - Interventional Pain Management 7214240464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Interventional Pain Management
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidewater Anesthesia Associates, PAGroup PAC ID 1254300361, 35 clinicians

Practice addresses (Care Compare)

100 Brown St
Chestertown, MD 21620-1435
Phone (410) 778-3300

6 Caulk LN
Easton, MD 21601-3854
Phone (410) 822-5559

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA09275900NJMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Anesthesia Associates, PA CurrentSince Jun 6, 2015 Accepting new patients

Locations

219 S Washington St
Easton, MD 21601

6 Caulk Ln
Easton, MD 21601
Phone (410) 822-5552

Interoperability endpoints

  • Direct secure messaging: canim483388@direct.umm.edu

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532649600000",
    "number": "1972763548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 S. WASHINGTON STREET",
            "address_2": "DEPT OF ANESTH",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "21601",
            "telephone_number": "609-955-4626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PATTERSON ST",
            "address_2": "RUTGERS UNIVERSITY- RWJMS DEPT OF ANESTHESIA",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "08901",
            "telephone_number": "609-955-4626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONSU",
        "first_name": "CANDY",
        "middle_name": "KYEWAA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-16",
        "last_updated": "2018-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NJ",
            "license": "25MA09275900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CANDY",
            "last_name": "ANIM",
            "middle_name": "KYEWAA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.