JEFFREY A BONACK (BA, MDIV) – Mental Health Counselor, NPI 1033724299

JEFFREY A BONACK (BA, MDIV) is a healthcare provider. based in Germantown, Wisconsin. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials BA, MDIV. They hold a License No. 5121-226 (WI). The NPI Number for JEFFREY A BONACK (BA, MDIV) is 1033724299

Main info

Male
5 Years Of Experience
Accepts Medicare Assignment
Name
JEFFREY A BONACK (BA, MDIV)
NPI
1033724299
Phone
(800) 438-1772
Address
W175N11120 STONEWOOD DR
Enumeration Date
14 September 2020
Last Update Date
9 November 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2623455562
Graduation Year
2021 (5 years ago)
PAC ID
9830534916
Group Practice PAC ID
0749233898
Professional Enrollment ID
I20240228002553
Address ID
WI530224799GEW175NDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:5State licenses:1Digital endpointsOther names

1,748 MENTAL HEALTH COUNSELOR in WI

Provider Addresses for JEFFREY A BONACK (BA, MDIV)

  • W175N11120 STONEWOOD DR

    GERMANTOWN, WI 530224799

    Phone: (800) 438-1772

    Fax: (262) 345-5562

    Type: Mailing

  • 16535 W Bluemound Rd Ste 305

    Brookfield, WI 530055936

    Phone: (800) 438-1772

    Fax: (262) 345-5562

    Type: Location

  • 2669 N RICHARDS ST

    MILWAUKEE, WI 532122850

    Phone: (800) 438-1772

    Fax: (262) 345-5562

    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: 2024-02-28

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
I20240228002553IMental Health CounselorWITBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 53022)

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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: 0749233898View full group profile
NameSpecialtyState
Clinical Social WorkerWI
Mental Health CounselorWI
Mental Health CounselorWI
Mental Health CounselorWI
Clinical PsychologistWI
Mental Health CounselorWI
Mental Health CounselorWI
Clinical Social WorkerWI
-WI
Clinical Social WorkerMI

Reviews

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Frequently asked questions

What number should I use to identify JEFFREY A BONACK (BA, MDIV) for billing?
Administrative and clinical systems typically use NPI 1033724299 for JEFFREY A BONACK (BA, MDIV).
Does the public listing show JEFFREY A BONACK (BA, MDIV) as active?
JEFFREY A BONACK (BA, MDIV)'s NPI record reflects an active status in NPPES.
What does the directory say JEFFREY A BONACK (BA, MDIV) does?
Insurance directories may phrase it differently, but here JEFFREY A BONACK (BA, MDIV) maps to Mental Health Counselor. Clinical services aligned with this taxonomy classification.
What geographic area is tied to JEFFREY A BONACK (BA, MDIV)?
JEFFREY A BONACK (BA, MDIV) is associated with Germantown, Wisconsin in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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