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DR. DAYNE KAWIKA BONZO DO
NPI 1437505963
Pediatrics in Eielson Afb, AK

Active since May 13, 2016PECOS Enrolled
2630 CENTRAL AVE # 3349, EIELSON AFB, AK 99702(907) 377-6455 Get Directions Write a Review

NPPES record last updated: August 20, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 20, 2026, Aug 25, 2022, Sep 11, 2020 and 2 more (5 updates tracked since 2016).

About Dr. Dayne Kawika Bonzo Do NPPES

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

DR. DAYNE KAWIKA BONZO DO (NPI 1437505963) is an individual pediatrics provider in Eielson Afb, Alaska, licensed in Alaska (199028) and active in the NPI registry since May 2016. He is enrolled in Medicare PECOS and maintains a secondary practice location in Fairbanks.

NPPES Registry Identity

NPI1437505963
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameDR. DAYNE KAWIKA BONZOCredential: DO
Location Address2630 CENTRAL AVE # 3349Eielson Afb, AK 99702-2301
Mailing Address2360 Central Ave #3349, Attn Dr. Dayne BonzoEielson Afb, AK 99702 · (907) 377-6455
Phone(907) 377-6455
Sole ProprietorYes
Enumeration DateMay 13, 2016
Last NPPES UpdateAugust 20, 20265 updates tracked since enumeration
NPPES CertifiedAugust 20, 2026
✔ NPI 1437505963 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Licenses✔ Licensed in AK · 199028✔ Licensed in OH · 34.013112
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Also ListedGeneral PracticeTaxonomy 208D00000X · License 34.013112 (OH)
2630 CENTRAL AVE # 3349, Eielson Afb, AK 99702
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Secondary Practice Location 1

Location 11650 Cowles StFairbanks, AK 99701-5998 · Phone (907) 459-3520 · Fax (907) 459-3554

Other Identifiers 1

Medicaid1733478AK

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Dayne Kawika Bonzo Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

2

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

Tanana Valley Clinic LLC
22 mi
Multi-Specialty
1001 NOBLE ST
Fairbanks, AK 99701
  • Reassigned Medicare billing, Alaska enrollment
  • 172 clinicians in this Medicare group
NPI 1922559558 (907) 459-3500
Peacehealth
833 mi
Critical Access
3100 TONGASS AVE
Ketchikan, AK 99901
  • Reassigned Medicare billing, Alaska enrollment
  • Also billed through NPI 1801965736 (Alaska)
  • 133 clinicians in this Medicare group
NPI 1396705539 (907) 228-8300

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 99702 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
$111.57 typical visit price
range $71.33 – $222.64
Typical copayment $27.89 (range $17.83 – $55.66)
Most-billed visit code 99203
Established Patient
$128.73 typical visit price
range $21.84 – $181.48
Typical copayment $32.18 (range $5.46 – $45.37)
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 11

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

MR. THOMAS MICHAEL URBANY IDMT
Military Health Care Provider (Independent Duty Medical Technicians)
2630 CENTRAL AVE # 3349
EIELSON AFB, AK 99702
Fairbanks North Star Borough (907) 669-0385
BRAD T DRISCOLL PHARMD
Pharmacist
2630 CENTRAL AVE # 3349
EIELSON AFB, AK 99702
Fairbanks North Star Borough (907) 377-1462
ERIC NOLL OD
Optometrist
2630 CENTRAL AVE # 3349
EIELSON AFB, AK 99702
Fairbanks North Star Borough (907) 377-1847
MRS. DANIELLE A LAWSON
Dental Hygienist
2630 CENTRAL AVE # 3349
EIELSON AFB, AK 99702
Fairbanks North Star Borough (907) 377-6767
MR. SAMUEL WADE CUIDON IDMT
Military Health Care Provider (Independent Duty Medical Technicians)
2630 CENTRAL AVE # 3349
EIELSON AFB, AK 99702
Fairbanks North Star Borough (405) 582-6048
NATHAN HAMILTON PA-C
Physician Assistant (Medical)
2630 CENTRAL AVE # 3349
EIELSON AFB, AK 99702
Fairbanks North Star Borough (907) 377-6657
NICHOLAS R MOOREHEAD PHD
Psychologist (Clinical)
2630 CENTRAL AVE # 3349
EIELSON AFB, AK 99702
Fairbanks North Star Borough (907) 377-3071
MRS. AMANDA NICHOLS
Military Health Care Provider (Independent Duty Medical Technicians)
2630 CENTRAL AVE # 3349
EIELSON AFB, AK 99702
Fairbanks North Star Borough (907) 377-6245

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dayne Bonzo's NPI number?

The NPI number for Dayne Bonzo is 1437505963. It was assigned to this individual provider in the NPPES registry on May 13, 2016.

Where is Dayne Bonzo located?

Dayne Bonzo practices at 2630 Central Ave # 3349, Eielson Afb, AK 99702. The listed phone number is (907) 377-6455.

What is Dayne Bonzo's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Dayne Bonzo enrolled in Medicare?

Yes. Dayne Bonzo is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Dayne Bonzo's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Dayne Bonzo reassigns Medicare benefits to 2 organizations: Tanana Valley Clinic LLC (Fairbanks, AK) and Peacehealth (Ketchikan, AK). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Dayne Bonzo's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Dayne Bonzo accept?

Health plans from Moda Health Plan, Inc., Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Dayne Bonzo as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Dayne Bonzo was last updated on August 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.