MARK W BONNER (MD) – Dermatology Physician, NPI 1811961600

MARK W BONNER (MD) is a healthcare provider. based in Dublin, Georgia. specializing in DERMATOLOGY, GENERAL PRACTICE, PATHOLOGY. They hold the professional credentials MD. They hold a License No. 057047 (GA). The NPI Number for MARK W BONNER (MD) is 1811961600

Main info

Male
40 Years Of Experience
Accepts Medicare Assignment
Name
MARK W BONNER (MD)
NPI
1811961600
Phone
(478) 275-7202
Address
2400 BELLEVUE RD STE 21A
Enumeration Date
16 February 2006
Last Update Date
3 May 2024

Doctor Profile

Medical School Name
UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Secondary Phone
2292761122
Graduation Year
1986 (40 years ago)
PAC ID
9537189865
Group Practice PAC ID
7113980855
Professional Enrollment ID
I20051201000790
Address ID
GA310153619CO408XXAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience74
Completeness75
Years active:20State licenses:1Digital endpointsOther names

409 DERMATOLOGY in GA

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Provider Addresses for MARK W BONNER (MD)

  • Bellevue Road, Sallynoggin, Dun Laoghaire-Sallynoggin East ED, Dún Laoghaire, Dún Laoghaire-Rathdown, County Dublin, Leinster, A96H312, Ireland

    DUBLIN, GA 310212890

    Phone: (478) 275-7202

    Fax: (478) 274-8418

    Type: Mailing

  • 1157, Forsyth Street, Macon, Bibb County, Georgia, 31201, United States

    MACON, GA 31201

    Phone: (478) 745-8581

    Fax: (478) 328-0438

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 146 Open Payments records for all available years, with a total value of $3,092.

Total Amount is formed as General ($3,092) + Research ($0) + Ownership ($0) = $3,092.

Last reported payment date: 2024-12-17 • Largest payer in this snapshot: ABBVIE INC. ($788).

Total Amount

$3,092

General + Research + Ownership

Payments

146

Total payment records

General Amount

$3,092

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-17

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-12-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20051201000790IDermatologyGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
17003Destruction of precancer skin growth, 2-14 growths677115$0
99213Established patient office or other outpatient visit, 20-29 minutes275218$0
99214Established patient office or other outpatient visit, 30-39 minutes203173$0
17000Destruction of precancer skin growth, 1 growth159141$0
11102Biopsy of related skin growth, first growth116110$0
View full utilization report →

Insurance plans in this area (ZIP 31021)

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Provider's Procedures

MARK W BONNER (MD) performs procedures in DERMATOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DERMATOLOGYGA11101Biopsy of each additional growth of skin and/or tissue5537

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7113980855View full group profile
NameSpecialtyState
Nurse PractitionerGA
Physician AssistantGA
Physician AssistantGA
Nurse PractitionerGA
D E R M A T O L O G YGA
Physician AssistantGA
-GA
D E R M A T O L O G YSC
Micrographic Dermatologic Surgery (Mds), Micrographic Dermatologic Surgery (Mds), Dermatology, DermatologyTX
P A T H O L O G YGA

Reviews

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Frequently asked questions

What is the 10-digit NPI for MARK W BONNER (MD)?
MARK W BONNER (MD) — NPI 1811961600 — is the standard way to identify this listing.
Can I rely on MARK W BONNER (MD) being an active provider?
As of the registry snapshot, MARK W BONNER (MD) is marked active.
What is MARK W BONNER (MD)'s specialty?
The listing groups MARK W BONNER (MD) with Dermatology Physician. Clinical services aligned with this taxonomy classification.
Does MARK W BONNER (MD) list a practice location?
Patients near Dublin, Georgia may find MARK W BONNER (MD) in results; validate coverage separately.
Is the information about MARK W BONNER (MD) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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