JOHN P. BONAVIA MD – NPI #1497716880
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

JOHN BONAVIA is a physician located in PORT WASHINGTON, WI. NPPES has assigned the NPI number 1497716880 to JOHN BONAVIA on March 28, 2006. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

The NPI profile was previously updated about 14 years ago on Jun 05, 2012. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for JOHN BONAVIA below.

NPI Profile for
JOHN P. BONAVIA

NPI Number
1497716880
Enumeration Date

(more than 20 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
JOHN P. BONAVIA
Credentials
MD
Primary location
1317 W GRAND AVE
PORT WASHINGTON, WI 53074-2075
Phone: (262) 268-6998 Fax:
Mailing address
4425 N PORT WASHINGTON RD
ATTN: CSMCP CLINIC CREDENTIALING
GLENDALE, WI 53212-1082
Phone: (414) 961-2750 Fax:
Sole Proprietor
No
Updated
Identifiers

Identifiers for JOHN BONAVIA

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDWI30656000
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207Q00000X
- Family Medicine (Primary)
WI 23729

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.