MATTHEW BONIN (NPI# 1992752554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992752554 |
| Entity Type | Individual |
| Full Name | MATTHEW BONIN |
| Credential | PA |
| Practice Address |
10475 Centurion Pkwy N Ste 201 Jacksonville FL 32256-5004 |
| Practice Telephone | 9042233321 |
| Practice Fax Number | 9042232169 |
| Mailing Telephone | 9042233321 |
| Mailing Fax Number | 9042232169 |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2019-05-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA9102671 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | CIGNA GOUT SVCS | 1174540001 | 01 |
| Street Address |
10475 CENTURION PKWY N STE 201 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32256-5004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912978149 | Christopher Roberts | Anesthesiology | 10475 Centurion Pkwy N Ste 201, Jacksonville, FL 32256-5004 | 2006-01-27 |
| 1346855095 | Maria Belaya | Physician Assistant | 10475 Centurion Pkwy N Ste 201, Jacksonville, FL 32256-5004 | 2020-09-10 |
| 1679193940 | Shwetaben Pinak Patel | Nurse Practitioner | 10475 Centurion Pkwy N Ste 201, Jacksonville, FL 32256-5004 | 2020-04-16 |
| 1861955700 | Pia Caesare Badger | Nurse Practitioner | 10475 Centurion Pkwy N Ste 201, Jacksonville, FL 32256-5004 | 2019-04-08 |
| 1588172357 | Sullybeth Torres | Nurse Practitioner | 10475 Centurion Pkwy N Ste 201, Jacksonville, FL 32256-5004 | 2018-01-16 |
| 1790204253 | Tara L Adams | Nurse Practitioner | 10475 Centurion Pkwy N Ste 201, Jacksonville, FL 32256 | 2017-09-15 |
| 1427401223 | Janell Miller | Nurse Practitioner | 10475 Centurion Pkwy N Ste 201, Jacksonville, FL 32256-5004 | 2016-07-15 |
| 1902263494 | Dorothy Slama | Registered Nurse | 10475 Centurion Pkwy N Ste 201, Jacksonville, FL 32256-5004 | 2016-01-28 |
| 1376954594 | Sathavaram Aravind Reddy | Anesthesiology | 10475 Centurion Pkwy N Ste 201, Jacksonville, FL 32256-5004 | 2014-05-09 |
| 1013198530 | Renee K Garrett | Physician Assistant | 10475 Centurion Pkwy N Ste 201, Jacksonville, FL 32256-5004 | 2007-11-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841890464 | Alice Sanchez | Dietitian, Registered | 7643 Gate Parkway, Suite 104-1128, Jacksonville, FL 32256 | 2020-11-01 |
| 1093327702 | Oaktree Dental LLC | Clinic/Center | 14595 Philips Highway, Jacksonville, FL 32256 | 2020-08-24 |
| 1538787866 | Tywanna Council | Massage Therapist | 4720 Salisbury Road #102, Jacksonville, FL 32256 | 2020-07-13 |
| 1275155368 | Christy Orellana | Social Worker | 5011 Gate Parkway Bldg 100 Suite 100, Jacksonville, FL 32256 | 2020-05-11 |
| 1376175117 | Diane Stover | Case Manager/Care Coordinator | 7001 A. C. Skinner Parkway, Jacksonville, FL 32256 | 2020-02-10 |
| 1982235859 | Sandra Josefina Baez Nunez | Nurse Practitioner | 10739 Deerwood Park Blvd, Suite 200, Jacksonville, FL 32256 | 2020-01-30 |
| 1205476496 | Point Meadows Dental Center, Inc. | Dentist | 10915 Baymeadows Rd, #106, Jacksonville, FL 32256 | 2020-01-15 |
| 1598324113 | Dhaval Yogeshkumar Shah | Dentist | 8206 Philips Hwy., Suite 21, Jacksonville, FL 32256 | 2019-06-07 |
| 1003472499 | Dade Medical, Inc. | Durable Medical Equipment & Medical Supplies | 9143 Philips Highway Suite 270, Jacksonville, FL 32256 | 2019-05-13 |
| 1003479726 | Nichole Bashara | Behavior Technician | 8383 Baymeadows Rd, Jacksonville, FL 32256 | 2019-04-18 |
| Find all providers in zip 32256 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831799527 | Emily Vander Zee | Physician Assistant | 6680 Bennett Creek Dr Apt 213, Jacksonville, FL 32216-0018 | 2020-10-30 |
| 1245830314 | Jonathan V Korah | Physician Assistant | 6650 Corporate Center Pkwy Apt 1108, Jacksonville, FL 32216-8725 | 2020-10-28 |
| 1255931473 | Rachel Gavrielle Stahly | Physician Assistant | 11438 Emuness Rd, Jacksonville, FL 32218-4050 | 2020-10-27 |
| 1760099071 | Laura Alexandra Ramos-heckman | Physician Assistant | 2014 Capistrano Dr, Jacksonville, FL 32224-3091 | 2020-09-30 |
| 1184230583 | Julian Clouse | Physician Assistant | 9803 Creekfront Rd Apt 307, Jacksonville, FL 32256-8449 | 2020-09-21 |
| 1962016717 | Stephanie Benton Gentry | Physician Assistant | 3179 Shadow Creek Rd, Jacksonville, FL 32226-2386 | 2020-08-31 |
| 1629689435 | Monarch Mental Health Association | Physician Assistant | 5393 Roosevelt Blvd Ste 8, Jacksonville, FL 32210-8424 | 2020-08-14 |
| 1235749425 | Nicole Lhommedieu | Physician Assistant | 3850 Marnie Pl, Jacksonville, FL 32223-3541 | 2020-08-03 |
| 1861002123 | Naw-am Acio Daniels | Physician Assistant | 7467 Volley Dr N, Jacksonville, FL 32277-9368 | 2020-08-03 |
| 1750906640 | Veronica Adriana Dediego | Physician Assistant | 915 W Monroe St Ste 300, Jacksonville, FL 32204-1177 | 2020-06-16 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32256 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.