Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Brandon Bonanno

Individual provider Physician Assistant · NPI 1518750397

Brandon Bonanno is a Physician Assistant in Stony Brook, New York. Qualified in 2025, 1 year ago. Practices with New York Spine and Brain Surgery, University Faculty Practice Corporat, a 59-clinician group and accepts Medicare assignment.

Years since qualifying
1
In the registry since
2025
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Practice location Address checks out

100 Nicolls Rd Hsc T12 Rm 080
Stony Brook, NY 11794-8122
Phone: (631) 444-1116
Fax: (631) 444-1535
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1518750397
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMay 26, 2025
Last updated in NPPESSeptember 4, 2025
Certification dateSeptember 4, 2025
Mailing address2 Whitcomb Ave, Mount Sinai, NY 11766-2229

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice New York Spine And Brain Surgery, University Faculty Practice Corporat — 59 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Stony Brook