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

Nicholas William Bonomo

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1104483114

Nicholas William Bonomo is a Psychiatry in Louisville, Kentucky. Graduated from University of Kentucky College of Medicine in 2012, 14 years ago. Practices with University of Louisville Physicians Inc, a 1,433-clinician group and accepts Medicare assignment. Licensed in Kentucky.

Years since qualifying
14
Trained at
University of Kentucky College of Medicine
Licensed in
KY
In the registry since
2019
Specialties on file
2
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Practice location Address checks out

1850 Bluegrass Ave
Louisville, KY 40215-1161
Phone: (502) 361-6731
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence R5660 (KY)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (KY)

Record details

NPI number1104483114
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 24, 2019
Last updated in NPPESJune 19, 2025
Certification dateJune 19, 2025

Medicare enrollment

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

Medicare specialtyPSYCHIATRY
Medical schoolUNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE
Graduated 2012 (14 years in practice)
Group practice University Of Louisville Physicians Inc — 1433 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Louisville