ALEXANDRA GANTT BUONOMO CRNP
NPI 1740994847
Nurse Practitioner - Pediatrics in Philadelphia, PA

Q: What is Alexandra Buonomo's NPI number?

The NPI number for Alexandra Buonomo is 1740994847. It was assigned to this individual provider in the NPPES registry on January 12, 2023.

Q: What is Alexandra Buonomo's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Q: When was this NPI record last updated?

The NPPES record for Alexandra Buonomo was last updated on January 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 January 12, 2023PECOS Enrolled

3500 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104(215) 590-1719(215) 590-1771 Get Directions Write a Review

NPPES record last updated: January 12, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Alexandra Gantt Buonomo Crnp NPPES

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

ALEXANDRA GANTT BUONOMO CRNP (NPI 1740994847) is an individual pediatrics provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (SP026846) and active in the NPI registry since January 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1740994847

Entity TypeIndividualFemale

Primary Taxonomy363LP0200X

Provider Legal NameALEXANDRA GANTT BUONOMOCredential: CRNP

Location Address3500 CIVIC CENTER BLVDPhiladelphia, PA 19104-4395

Mailing Address3500 Civic Center BlvdPhiladelphia, PA 19104-4395 · (215) 590-1719 · Fax (215) 590-1771

Phone(215) 590-1719

Fax(215) 590-1771

Sole ProprietorNo

Enumeration DateJanuary 12, 2023

NPPES CertifiedJanuary 12, 2023

✔ NPI 1740994847 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0200X

License✔ Licensed in PA · SP026846

3500 CIVIC CENTER BLVD, Philadelphia, PA 19104

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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)

Alexandra Gantt Buonomo Crnp 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19104 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

$92.69 typical visit price

range $59.88 – $180.99

Typical copayment $23.17 (range $14.97 – $45.24)

Most-billed visit code 99203

Established Patient

$105.21 typical visit price

range $19.30 – $147.29

Typical copayment $26.30 (range $4.82 – $36.82)

Most-billed visit code 99214

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.

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