KEVIN JOHN BOHNSACK (M.D.) – Family Medicine Physician, NPI 1205825023
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,418 FAMILY PRACTICE in MI
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Provider Addresses for KEVIN JOHN BOHNSACK (M.D.)
Domino's Farms Office Park, 24, Frank Lloyd Wright Drive, Domino Farms, Ann Arbor Charter Township, Washtenaw County, Michigan, 48105, United States
PO BOX 0446 LOBY J
ANN ARBOR, MI 481059484
Phone: (734) 327-0872
Type: Mailing
870, East Arkona Road, Milan, Washtenaw County, Michigan, 48160, United States
STE 100
MILAN, MI 481609770
Phone: (734) 439-2429
Type: Location
24 FRANK LLOYD WRIGHT DR STE J2000
ANN ARBOR, MI 481059484
Phone: (734) 747-6766
Type: Mailing
7575 GRAND RIVER RD STE 210
BRIGHTON, MI 481149379
Phone: (810) 844-7950
Fax: (810) 494-6895
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2011-06-27
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20110627000345 | I | Family Practice | MI | TBD |
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.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 48105)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Hospitalist, Internal Medicine | MI | |
| Interventional Radiology | MI | |
| Cardiovascular Disease (Cardiology) | MI | |
| Physician Assistant | MI | |
| Physician Assistant | MI | |
| - | MI | |
| - | MI | |
| Internal Medicine, Geriatric Medicine | MI | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MI | |
| Hospitalist, Internal Medicine | MI |
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