Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Danielle Nicole Bonifazio, PA-C

Individual provider Physician Assistant · NPI 1083440275

Danielle Nicole Bonifazio, PA-C is a Physician Assistant in Bay Shore, New York. Qualified in 2024, 2 years ago. Practices with North Shore-Lij Medical PC, a 6,350-clinician group and accepts Medicare assignment.

Years since qualifying
2
In the registry since
2024
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

301 E Main St
Bay Shore, NY 11706-8408
Phone: (631) 968-3000
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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 number1083440275
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 12, 2024
Last updated in NPPESSeptember 12, 2024
Certification dateSeptember 12, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice North Shore-Lij Medical Pc — 6350 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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