MCKENZIE BONIFIELD
NPI 1205411204
Nurse Practitioner - Family in Carbondale, IL

Q: What is Mckenzie Bonifield's NPI number?

The NPI number for Mckenzie Bonifield is 1205411204. It was assigned to this individual provider in the NPPES registry on March 11, 2021.

Q: What is Mckenzie Bonifield's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since March 11, 2021PECOS EnrolledAccepts Medicare Assignment

400 S LEWIS LN, CARBONDALE, IL 62901(618) 519-9200 Get Directions Write a Review

NPPES record last updated: March 17, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 17, 2021, Mar 11, 2021 (2 updates tracked since 2021).

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About Mckenzie Bonifield NPPES

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

MCKENZIE BONIFIELD (NPI 1205411204) is an individual family provider in Carbondale, Illinois, licensed in Illinois (209022703) and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1205411204

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMCKENZIE BONIFIELD

Location Address400 S LEWIS LNCarbondale, IL 62901-3547

Mailing Address109 California St, Po Box 577Carterville, IL 62918-0577 · (618) 519-9200 · Fax (618) 985-4635

Phone(618) 519-9200

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateMarch 11, 2021

Last NPPES UpdateMarch 17, 20212 updates tracked since enumeration

NPPES CertifiedMarch 17, 2021

✔ NPI 1205411204 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in IL · 209022703

400 S LEWIS LN, Carbondale, IL 62901

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.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

Mckenzie Bonifield 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 ID1355758061

PECOS Enrollment IDI20210325000273

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62901 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

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

Most-billed visit code 99214

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 16

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

POORVA TALAPATRA M.ED., LCPC

Counselor (Mental Health)