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

Nicholas Bonomo

Individual provider Surgical Physician Assistant · NPI 1386975571

Nicholas Bonomo is a Physician Assistant in Waterbury, Connecticut. Qualified in 2009, 17 years ago. Practices with Trinity Health of New England Provider Network Organization Inc, a 635-clinician group and accepts Medicare assignment. Licensed in Connecticut.

Years since qualifying
17
Licensed in
CT
In the registry since
2010

Practice location Address checks out

56 Franklin St
Waterbury, CT 06706-1253
Phone: (203) 709-6000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 1090862 (CT)

Record details

NPI number1386975571
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 27, 2010
Last updated in NPPESOctober 19, 2021
Certification dateOctober 19, 2021
Mailing address46 S Cherry St, Unit 244, Wallingford, CT 06492-3596

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Trinity Health Of New England Provider Network Organization Inc — 635 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Waterbury