MR. BRIAN KEITH BONOMO PAC
NPI 1124012596
Physician Assistant in Lecanto, FL

Active since August 31, 2005PECOS EnrolledAccepts Medicare Assignment
87.85/100
CMS Quality Rating
525 N DACIE PT, LECANTO, FL 34461(352) 746-2200(352) 746-9320 Get Directions Write a Review

NPPES record last updated: November 12, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Mr. Brian Keith Bonomo Pac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. BRIAN KEITH BONOMO PAC (NPI 1124012596) is an individual physician assistant in Lecanto, Florida, licensed in Florida (PA9101264) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS and is a graduate of Other (2000).

NPPES Registry Identity

NPI1124012596
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. BRIAN KEITH BONOMOCredential: PAC
Location Address525 N DACIE PTLecanto, FL 34461-8399
Mailing Address4651 Van Dyke RdLutz, FL 33558-4880 · (813) 321-1786 · Fax (813) 321-1787
Fax(352) 746-9320
Sole ProprietorNo
Medical School CMSOtherGraduated 2000
Enumeration DateAugust 31, 2005
Last NPPES UpdateNovember 12, 2022
NPPES CertifiedNovember 12, 2022
NPI 1124012596 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in FL · PA9101264
Definition

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.

525 N DACIE PT, Lecanto, FL 34461

Other Identifiers 2

Other970015048FL · Srrga
Medicaid290989800FL

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Mr. Brian Keith Bonomo Pac is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2860526803
PECOS Enrollment IDI20100812001044
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 31

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Destruction of precancer skin growth, 2-14 growths 17003
This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.
3,969 services775 patients
Established patient office or other outpatient visit, 20-29 minutes 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
2,969 services1,996 patients
Destruction of precancer skin growth, 1 growth 17000
"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.
1,585 services1,130 patients
Biopsy of related skin growth, first growth 11102
A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.
922 services727 patients
Established patient office or other outpatient visit, 10-19 minutes 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
461 services377 patients
Established patient office or other outpatient visit, 30-39 minutes 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
226 services177 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 34461 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

87.85/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality85
Promoting Interoperability87
Improvement Activities40

Reported Quality Measures

Advance Care Plan
100%3,925 patients5/55-star benchmark: 100%
Melanoma: Continuity of Care - Recall System
100%435 patients
Melanoma: Coordination of Care
100%46 patients
Provide Patients Electronic Access to Their Health Information
68%2,291 patients2/55-star benchmark: 100%
Psoriasis: Clinical Response to Systemic Medications
99%74 patients
Tuberculosis Screening Prior to First Course of Biologic and/or Immune Response Modifier Therapy
100%26 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dermatology
525 N DACIE PT
LECANTO, FL 34461
Nurse Practitioner
525 N DACIE PT
LECANTO, FL 34461
Nurse Practitioner
525 N DACIE PT
LECANTO, FL 34461
Dermatology (MOHS-Micrographic Surgery)
525 N DACIE PT
LECANTO, FL 34461
Dermatology
525 N DACIE PT
LECANTO, FL 34461
Dermatology (MOHS-Micrographic Surgery)
525 N DACIE PT
LECANTO, FL 34461
Nurse Practitioner (Gerontology)
525 N DACIE PT
LECANTO, FL 34461
Nurse Practitioner
525 N DACIE PT
LECANTO, FL 34461

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1124012596, enumerated as an "individual" on August 31, 2005.

The provider is located at 525 N DACIE PT LECANTO, FL 34461 and the phone number is (352) 746-2200.

Physician Assistant with taxonomy code 363A00000X.

The provider might be accepting Accepts: AvMed, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.