Mr Michael Robert Bonisa, PA-C is a medicare enrolled "Physician Assistant" physician in Charlotte, North Carolina. He graduated from medical school in 1999 and has 25 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Mecklenburg Radiology Associates Pa and his current practice location is
3623 Latrobe Dr, Suite 216, Charlotte, North Carolina. You can reach out to his office (for appointments etc.) via phone at
(704) 332-1291.
Mr Michael Robert Bonisa is licensed to practice in North Carolina (license number 000102829) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1760444723.
Physician's Profile
| Full Name | Mr Michael Robert Bonisa |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Experience | 25 Years |
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| Location | 3623 Latrobe Dr, Charlotte, North Carolina |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mr Michael Robert Bonisa graduated from medical school in 1999
NPI Data:
- NPI Number: 1760444723
- Provider Enumeration Date: 04/05/2006
- Last Update Date: 02/03/2023
Medicare PECOS Information:
- PECOS PAC ID: 2163470113
- Enrollment ID: I20050106000768
Medical Identifiers
Medical identifiers for Mr Michael Robert Bonisa such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1760444723 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2085R0204X | Radiology - Vascular & Interventional Radiology | 000102829 (North Carolina) | Secondary |
| 363A00000X | Physician Assistant | 000102829 (North Carolina) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Mecklenburg Radiology Associates Pa | 6800789587 | 80 |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Michael Robert Bonisa is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Michael Robert Bonisa, PA-C
Po Box 221249,
Charlotte, NC 28222-1249
Ph: (704) 332-1291 | Mr Michael Robert Bonisa, PA-C
3623 Latrobe Dr, Suite 216,
Charlotte, NC 28211
Ph: (704) 332-1291 |
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