NICHOLAS WILLIAM BONOMO
NPI 1104483114
Psychiatry & Neurology - Psychiatry in Louisville, KY

Q: What is Nicholas Bonomo's NPI number?

The NPI number for Nicholas Bonomo is 1104483114. It was assigned to this individual provider in the NPPES registry on May 24, 2019.

Q: What is Nicholas Bonomo's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Q: When was this NPI record last updated?

The NPPES record for Nicholas Bonomo was last updated on June 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 24, 2019PECOS EnrolledAccepts Medicare Assignment

1850 BLUEGRASS AVE, LOUISVILLE, KY 40215(502) 361-6731 Get Directions Write a Review

NPPES record last updated: June 19, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 19, 2025, May 24, 2019 (2 updates tracked since 2019).

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About Nicholas William Bonomo NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICHOLAS WILLIAM BONOMO (NPI 1104483114) is an individual psychiatry provider in Louisville, Kentucky, licensed in Kentucky (R5660) and active in the NPI registry since May 2019. He is enrolled in Medicare PECOS, is affiliated with Jewish Hospital & St Mary's Healthcare, and is a graduate of University Of Kentucky College Of Medicine (2012).

NPPES Registry Identity

NPI1104483114

Entity TypeIndividualMale

Primary Taxonomy2084P0800X

Provider Legal NameNICHOLAS WILLIAM BONOMO

Location Address1850 BLUEGRASS AVELouisville, KY 40215-1161

Mailing Address1850 Bluegrass AveLouisville, KY 40215-1161 · (502) 361-6731

Phone(502) 361-6731

Sole ProprietorNo

Medical School CMSUniversity Of Kentucky College Of MedicineGraduated 2012

Enumeration DateMay 24, 2019

Last NPPES UpdateJune 19, 20252 updates tracked since enumeration

NPPES CertifiedJune 19, 2025

✔ NPI 1104483114 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0800X

License✔ Licensed in KY · R5660

Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1850 BLUEGRASS AVE, Louisville, KY 40215

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nicholas William Bonomo is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6507372810

PECOS Enrollment IDI20250723001604

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Jewish Hospital & St Mary's Healthcare

Acute Care Hospitals · Louisville, KY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180040

Location200 Abraham Flexner WayLouisville, KY 40202 · Jefferson County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40215 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$162.27 typical visit price

range $52.76 – $162.27

Typical copayment $40.56 (range $13.19 – $40.56)

Most-billed visit code 99205

Established Patient

$66.24 typical visit price

range $16.53 – $131.99

Typical copayment $16.56 (range $4.13 – $32.99)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RICHARD BOOTH HARRIS D.O.

Anesthesiology

1850 BLUEGRASS AVE
LOUISVILLE, KY 40215

Jefferson County (502) 361-6617

SCOTT BRIAN BABIN M.D.

Radiology (Diagnostic Radiology)

1850 BLUEGRASS AVE
LOUISVILLE, KY 40215

Jefferson County (865) 584-7376

PRAVEEN SESHABHATTAR M.D.

Internal Medicine

1850 BLUEGRASS AVE, HIPS DEPT
LOUISVILLE, KY 40215

Jefferson County (502) 367-3360

CARRIE ANNE ROBERTS CRNA

Nurse Anesthetist, Certified Registered

1850 BLUEGRASS AVE
LOUISVILLE, KY 40215

Jefferson County (502) 852-5851

DAVID M PASSAFIUME MD

Anesthesiology

1850 BLUEGRASS AVE
LOUISVILLE, KY 40215

Jefferson County (502) 361-6017

DR. JOHN MARSHALL WILSON MD

Anesthesiology

1850 BLUEGRASS AVE
LOUISVILLE, KY 40215

Jefferson County (502) 361-6617

SAUNDRA L. SMALLEY CRNA

Nurse Anesthetist, Certified Registered

1850 BLUEGRASS AVE
LOUISVILLE, KY 40215

Jefferson County (502) 361-6617

ANN M. LOMBARDI M.D.

Internal Medicine

1850 BLUEGRASS AVE
LOUISVILLE, KY 40215

Jefferson County (502) 367-3360

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicholas Bonomo's NPI number?

The NPI number for Nicholas Bonomo is 1104483114. It was assigned to this individual provider in the NPPES registry on May 24, 2019.

Where is Nicholas Bonomo located?

Nicholas Bonomo practices at 1850 Bluegrass Ave, Louisville, KY 40215. The listed phone number is (502) 361-6731.

What is Nicholas Bonomo's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Nicholas Bonomo enrolled in Medicare?

Yes. Nicholas Bonomo is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Nicholas Bonomo accept?

Health plans from CareSource list Nicholas Bonomo as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Nicholas Bonomo affiliated with any hospitals?

According to CMS data, Nicholas Bonomo is affiliated with Jewish Hospital & St Mary's Healthcare.

When was this NPI record last updated?

The NPPES record for Nicholas Bonomo was last updated on June 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.