BRIAN BONZO
NPI 1174302806
Nurse Anesthetist, Certified Registered in Jacksonville, FL

Q: What is Brian Bonzo's NPI number?

The NPI number for Brian Bonzo is 1174302806. It was assigned to this individual provider in the NPPES registry on September 22, 2023.

Q: What is Brian Bonzo's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Q: When was this NPI record last updated?

The NPPES record for Brian Bonzo was last updated on October 10, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 22, 2023Accepts Medicare Assignment

2080 CHILD ST DEPT 5000, JACKSONVILLE, FL 32214(904) 542-7300 Get Directions Write a Review

NPPES record last updated: October 10, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Brian Bonzo NPPES

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

BRIAN BONZO (NPI 1174302806) is an individual nurse anesthetist, certified registered in Jacksonville, Florida, licensed in Florida (RN11028851) and active in the NPI registry since September 2023. He is a graduate of Other (2023).

NPPES Registry Identity

NPI1174302806

Entity TypeIndividualMale

Primary Taxonomy367500000X

Provider Legal NameBRIAN BONZO

Location Address2080 CHILD ST DEPT 5000Jacksonville, FL 32214-5000

Mailing Address2080 Child St Dept 5000Jacksonville, FL 32214-5000 · (904) 542-7300

Phone(904) 542-7300

Sole ProprietorYes

Medical School CMSOtherGraduated 2023

Enumeration DateSeptember 22, 2023

Last NPPES UpdateOctober 10, 2023

NPPES CertifiedOctober 10, 2023

✔ NPI 1174302806 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367500000X

License✔ Licensed in FL · RN11028851

Definition

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

Also ListedRegistered NurseTaxonomy 163W00000X · License RN49804 (RI)

2080 CHILD ST DEPT 5000, Jacksonville, FL 32214

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Brian Bonzo 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 ID8628501061

PECOS Enrollment IDI20241024000555

Medicare Billing Reassignments

Medicare enrollment records show Brian Bonzo reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Jax Anesthesia Providers LLC

9.3 mi

Anesthesiology

4800 BELFORT RD
Jacksonville, FL 32256

Reassigned Medicare billing, Florida enrollment
121 clinicians in this Medicare group

NPI 1245271154 (904) 483-5850

Anesthesia Dynamics LLC

194 mi

Anesthesiology

206 2ND ST E
Bradenton, FL 34208

Reassigned Medicare billing, Florida enrollment
1,887 clinicians in this Medicare group

NPI 1073001012 (888) 851-4642

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims

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

Anesthesia for other procedure on large bowel using an endoscope 00811

Anesthesia for an endoscopic procedure on the large bowel ensures comfort and relaxation during the procedure. You'll be given medication to make you drowsy or asleep, eliminating any discomfort. The medication can be administered through a vein or inhaled.

11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32214 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

$130.04 typical visit price

range $56.00 – $171.84

Typical copayment $32.51 (range $14.00 – $42.96)

Most-billed visit code 99204

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.

Other Providers at the Same Location NPPES 20

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

MICHELLE ALICIA COY DNP

Nurse Anesthetist, Certified Registered