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MS. MARY M BONOMO P.A.
NPI 1376861690
Physician Assistant - Surgical in Philadelphia, PA

Active since May 11, 2010PECOS Enrolled
5501 OLD YORK RD, KLEIN 510, PHILADELPHIA, PA 19141(215) 456-6933 Get Directions Write a Review

NPPES record last updated: May 11, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ms. Mary M Bonomo P.a. NPPES

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

MS. MARY M BONOMO P.A. (NPI 1376861690) is an individual surgical provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MA051566) and active in the NPI registry since May 2010. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1376861690
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NameMS. MARY M BONOMOCredential: P.A.
Location Address5501 OLD YORK RD, KLEIN 510Philadelphia, PA 19141-3018
Mailing Address5501 Old York Rd, Klein 510Philadelphia, PA 19141-3018 · (215) 456-6933
Phone(215) 456-6933
Sole ProprietorNo
Enumeration DateMay 11, 2010
✔ NPI 1376861690 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in PA · MA051566
5501 OLD YORK RD, Philadelphia, PA 19141
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Mary M Bonomo P.a. 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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
53 services12 patients

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tacrolimus, immediate release, oral, 1 mg J7507
Treatment-Treatment - Miscellaneous · category RX029N
3 suppliers18 claims3,600 services$0.27 avg. paid by Medicare
Prednisone, immediate release or delayed release, oral, 1 mg J7512
Treatment-Treatment - Miscellaneous · category RX029N
1 supplier17 claims3,900 services$0.01 avg. paid by Medicare
Mycophenolic acid, oral, 180 mg J7518
Treatment-Treatment - Miscellaneous · category RX029N
3 suppliers17 claims1,740 services$0.88 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511
Treatment-Chemotherapy · category RH012N
4 suppliers21 claims21 services$18.86 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512
Treatment-Chemotherapy · category RH012N
3 suppliers44 claims46 services$12.57 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

KENNETH KLECKNER MD
Emergency Medicine
5501 OLD YORK RD, EINSTEIN MEDICAL CENTER - PHILADELPHIA
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-6679
MS. AMMAN HASSAN MD
Pediatrics
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-3810
TAYLOR NICOLE THOMPSON PA-C
Physician Assistant (Medical)
5501 OLD YORK RD, KORMAN BUILDING SUITE 202
PHILADELPHIA, PA 19141
Philadelphia County (215) 254-2630
STEPHEN RYAN CHEN
Orthopaedic Surgery
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7890
DR. DHRUV SHARMA MD
Student in an Organized Health Care Education/Training Program
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7890
TIMOTHY DANIEL GARDNER DO
Student in an Organized Health Care Education/Training Program
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7890
DR. JONATHAN THOMAS LUCIANI DO
Student in an Organized Health Care Education/Training Program
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7890
ASHIKA KAPOOR MD
Psychiatry & Neurology (Psychiatry)
5501 OLD YORK RD
PHILA, PA 19141
Philadelphia County (215) 456-8103

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 Bonomo's NPI number?

The NPI number for Mary Bonomo is 1376861690. It was assigned to this individual provider in the NPPES registry on May 11, 2010.

Where is Mary Bonomo located?

Mary Bonomo practices at 5501 Old York Rd Klein 510, Philadelphia, PA 19141. The listed phone number is (215) 456-6933.

What is Mary Bonomo's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Mary Bonomo enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Mary Bonomo was last updated on May 11, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.