DR. MARY ELIZABETH BONAFEDE M.D.
NPI 1376627661
Pediatrics - Pediatric Infectious Diseases in West Islip, NY

Q: What is Mary Bonafede's NPI number?

The NPI number for Mary Bonafede is 1376627661. It was assigned to this individual provider in the NPPES registry on October 24, 2006.

Q: What is Mary Bonafede's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Infectious Diseases, with taxonomy code 2080P0208X.

Q: When was this NPI record last updated?

The NPPES record for Mary Bonafede was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years 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 October 24, 2006PECOS Enrolled

239 HIGBIE LN, WEST ISLIP, NY 11795(631) 376-3000 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Dr. Mary Elizabeth Bonafede M.d. NPPES

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

DR. MARY ELIZABETH BONAFEDE M.D. (NPI 1376627661) is an individual pediatric infectious diseases provider in West Islip, New York, licensed in New York (208119) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1376627661

Entity TypeIndividualFemale

Primary Taxonomy2080P0208X

Provider Legal NameDR. MARY ELIZABETH BONAFEDECredential: M.D.

Location Address239 HIGBIE LNWest Islip, NY 11795-2825

Mailing Address92 S Montgomery AveBay Shore, NY 11706-8808 · (631) 969-3865

Phone(631) 376-3000

Sole ProprietorNo

Enumeration DateOctober 24, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1376627661 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric Infectious DiseasesAllopathic & Osteopathic Physicians

Taxonomy Code2080P0208X

License✔ Licensed in NY · 208119

Definition

A pediatrician trained to care for children in the diagnosis, treatment and prevention of infectious diseases. This specialist can apply specific knowledge to affect a better outcome for pediatric infections with complicated courses, underlying diseases that predispose to unusual or severe infections, unclear diagnoses, uncommon diseases and complex or investigational treatments.

239 HIGBIE LN, West Islip, NY 11795

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mary Elizabeth Bonafede M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Mary Bonafede reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Optum Medical Care, P.C.

40 mi

Cardiovascular Disease

90 SOUTH BEDFORD RD, MT KISCO MEDICAL GROUP PC
Mount Kisco, NY 10549

Reassigned Medicare billing, New York enrollment
Medicare enrollment name: Optum Medical Care PC
1,601 clinicians in this Medicare group

NPI 1982643003 (914) 241-1050

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 3

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

TIMOTHY GEORGE M.D.

Pediatrics

239 HIGBIE LN
WEST ISLIP, NY 11795

Suffolk County (631) 376-6000

DR. SAUMIL HARDEV TRIVEDI MD

Pediatrics

239 HIGBIE LN
WEST ISLIP, NY 11795

Suffolk County (631) 376-6000

RACHAEL VANCURA M. D.

Pediatrics

239 HIGBIE LN
WEST ISLIP, NY 11795

Suffolk County (631) 376-6000

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 Mary Bonafede's NPI number?

The NPI number for Mary Bonafede is 1376627661. It was assigned to this individual provider in the NPPES registry on October 24, 2006.

Where is Mary Bonafede located?

Mary Bonafede practices at 239 Higbie Ln, West Islip, NY 11795. The listed phone number is (631) 376-3000.

What is Mary Bonafede's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Infectious Diseases, with taxonomy code 2080P0208X.

Is Mary Bonafede enrolled in Medicare?

Yes. Mary Bonafede is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mary Bonafede's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mary Bonafede reassigns Medicare benefits to Optum Medical Care, P.C. (Mount Kisco, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mary Bonafede's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mary Bonafede was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years 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.