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Deactivated NPI 1235134792 Deactivated / Inactive NPI Male Practitioner

Dr. Michael J Bonomo , MD

Urology • West Orange, NJ

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Michael Bonomo has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 20, 2005
NPI Deactivation Date August 31, 2017
Total Practice Duration ~12 Years of Practice (2005 – 2017)

Professional Overview & Biography Verified Profile Summary

Dr. Michael Bonomo, MD was a registered Urology practicing in West Orange, NJ. Throughout an active medical career spanning 12 years, Dr. Bonomo provided care at the practice location at 741 NORTHFIELD AVE until profile deactivation on 2017-08-31.

Practice Location & Contact Primary Location

Practice Address

741 Northfield Ave
Ste 206

West Orange, NJ 070521104

Telephone 9733256100
Fax 9733252495
Associated Practice Facility / Clinic
🏢 Consultants In Cardiology Facility NPI 1740239706

Specialty Benchmarks & Practice Insights

Comparative analytics for Urology in West Orange, NJ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 41.0 Yrs
State Avg: 28.6 Yrs
Regional Practice Density
10 Specialists

Practicing in West Orange, NJ (474 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Urology Primary Specialty

NUCC Taxonomy Code: 208800000X

State License NJ MA026651

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
NPI 1003812975

Doctor of Medicine (M.D.)

NPI 1235135104

Doctor of Medicine (M.D.)

NPI 1356347223

Doctor of Medicine (M.D.)

Rebecca Korabelnikov

Nurse Practitioner

NPI 1871473819

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated August 31, 2017

Record deactivated on August 31, 2017

NPI Profile Active April 30, 2009

NPI status registered as active in NPPES database

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Updated Practice Location April 30, 2009

Registered at 741 NORTHFIELD AVE, STE 206, WEST ORANGE, NJ 070521104 (Tel: 9733256100)

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Updated Business Mailing Address April 30, 2009

Registered at 741 NORTHFIELD AVE, STE 206, WEST ORANGE, NJ 070521104 (Tel: 9733256100)

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Provider Name / Credentials Updated April 30, 2009

Recorded as MICHAEL BONOMO, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) April 30, 2009

Urology (License #MA026651 in NJ)

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Initial NPI Registration & Enumeration June 20, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1235134792
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 20, 2005
Last Update: April 30, 2009
Deactivation Date: August 31, 2017

Mailing Address

741 Northfield Ave, Ste 206

West Orange, NJ 070521104

Phone: 9733256100

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.