MARK A BONASSO (PA-C) – Physician Assistant, NPI 1396764841

MARK A BONASSO (PA-C) is a healthcare provider. based in South haven, Michigan. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 5601003771 (MI). The NPI Number for MARK A BONASSO (PA-C) is 1396764841

Main info

Male
28 Years Of Experience
Accepts Medicare Assignment
Name
MARK A BONASSO (PA-C)
NPI
1396764841
Phone
(269) 639-2866
Address
950 S BAILEY AVE STE 1
Enumeration Date
18 July 2006
Last Update Date
19 March 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7345395000
Graduation Year
1998 (28 years ago)
PAC ID
5698856128
Group Practice PAC ID
3779496856
Professional Enrollment ID
I20080122000666
Address ID
MI481083347AN1801XCIRX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

6,069 PHYSICIAN ASSISTANT in MI

Provider Addresses for MARK A BONASSO (PA-C)

  • 950 S BAILEY AVE STE 1

    SOUTH HAVEN, MI 490908744

    Phone: (269) 639-2866

    Type: Location

  • 700, Kms Place, Research Park, Ann Arbor, Washtenaw County, Michigan, 48108, United States

    ANN ARBOR, MI 48108

    Phone: (734) 936-2047

    Type: Mailing

  • Mott Children's Hospital and Von Voigtlander Women's Hospital, 1500, East Medical Center Drive, Ann Arbor, Washtenaw County, Michigan, 48109, United States

    B1 FLOOR UNIVERSITY HOSPITAL RECP C

    ANN ARBOR, MI 481095030

    Phone: (734) 936-4566

    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: 2008-01-22

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
I20080122000666IPhysician AssistantMITBD

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
76937Ultrasonic guidance for blood vessel access6261$0
99152Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes5959$0
77001Fluoroscopic guidance for insertion or removal of central vein access device5353$0
36561Insertion of central venous tube with port (5 years or older)4141$0
36590Removal of central venous tube with port or pump1717$0
View full utilization report →

Insurance plans in this area (ZIP 49090)

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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: 3779496856View full group profile
NameSpecialtyState
G A S T R O E N T E R O L O G YFL
Physical Medicine And RehabilitationMI
A N E S T H E S I O L O G YMI
Internal Medicine, Pediatric MedicineIL
-MI
Physician AssistantMI

Reviews

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Frequently asked questions

Does MARK A BONASSO (PA-C) have a public NPI I can cite?
Public records show MARK A BONASSO (PA-C) under NPI 1396764841.
Quick check: is MARK A BONASSO (PA-C) active?
Public NPPES data shows MARK A BONASSO (PA-C) with an active NPI status right now.
How should patients interpret MARK A BONASSO (PA-C)'s specialty?
The extract shows Physician Assistant for MARK A BONASSO (PA-C). Clinical services aligned with this taxonomy classification.
Can patients visit MARK A BONASSO (PA-C) in South Haven, Michigan?
For routing, start with South Haven, Michigan for MARK A BONASSO (PA-C), then verify phone and hours locally.
Can I export MARK A BONASSO (PA-C)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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