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

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: October 18, 2026.

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, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignment

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

Children's Health Care Associates
Same address
Pediatrics
34TH & CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA
Philadelphia, PA 19104
  • Reassigned Medicare billing, Pennsylvania enrollment
  • Medicare enrollment name: Childrens Health Care Associates Inc
  • 1,225 clinicians in this Medicare group
NPI 1619062668 (215) 590-1000

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

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.

DR. REBECCA M HAMMONDS PH.D.
Psychologist (Clinical)
3500 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000
BRITTANY E HOYLE PA-C
Physician Assistant
3500 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-3376
ELIZABETH ALANA PUMIGLIA CRNP
Nurse Practitioner
3500 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (518) 225-7417
DR. KEMAR VANINA PRUSSIEN-OKAFOR PHD
Psychologist (Clinical)
3500 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000
ANJALI RAJESH CHAUHAN MS
Genetic Counselor, MS
3500 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-4389
LUCY BERMAN BRANCAZIO MS
Genetic Counselor, MS
3500 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-4033
DR. CHRISTOPHER JOHN LAROSA MD
Pediatrics (Pediatric Nephrology)
3500 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000
STEPHANIE LAUREN GONZALES
Pediatrics (Pediatric Endocrinology)
3500 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (267) 391-8776

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 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.

Where is Alexandra Buonomo located?

Alexandra Buonomo practices at 3500 Civic Center Blvd, Philadelphia, PA 19104. The listed phone number is (215) 590-1719.

What is Alexandra Buonomo's specialty?

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

Is Alexandra Buonomo enrolled in Medicare?

Yes. Alexandra Buonomo is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Alexandra Buonomo's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Alexandra Buonomo reassigns Medicare benefits to Children's Health Care Associates (Philadelphia, PA). 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 Alexandra Buonomo'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 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.