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JOHN P BONAVIA MD
NPI 1497716880
Family Medicine in Port Washington, WI

Active since March 28, 2006
1317 W GRAND AVE, PORT WASHINGTON, WI 53074(262) 268-6998 Get Directions Write a Review

NPPES record last updated: June 5, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About John P Bonavia Md NPPES

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

JOHN P BONAVIA MD (NPI 1497716880) is an individual family medicine provider in Port Washington, Wisconsin, licensed in Wisconsin (23729) and active in the NPI registry since March 2006.

NPPES Registry Identity

NPI1497716880
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameJOHN P BONAVIACredential: MD
Location Address1317 W GRAND AVEPort Washington, WI 53074-2075
Mailing Address4425 N Port Washington Rd, Attn: Csmcp Clinic CredentialingGlendale, WI 53212-1082 · (414) 961-2750
Phone(262) 268-6998
Sole ProprietorNo
Enumeration DateMarch 28, 2006
Last NPPES UpdateJune 5, 2012
✔ NPI 1497716880 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in WI · 23729
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1317 W GRAND AVE, Port Washington, WI 53074
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Other Identifiers 2

Medicaid30656000WI
Medicare UPINB51644WI

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.

NEAL Z. POTASH MS
Social Worker
1317 W GRAND AVE
PORT WASHINGTON, WI 53074
Ozaukee County (262) 284-5789
MARCY DRUMMY MS, LPC
Counselor (Professional)
1317 W GRAND AVE
PORT WASHINGTON, WI 53074
Ozaukee County (262) 284-5789
MRS. KATHLEEN NOETZEL MS CCC-SLP
Speech-Language Pathologist
1317 W GRAND AVE
PORT WASHINGTON, WI 53074
Ozaukee County (262) 284-2261
BONNIE HALPER LPC
Counselor (Professional)
1317 W GRAND AVE
PORT WASHINGTON, WI 53074
Ozaukee County (262) 284-5789
MS. KIM MARIE RASMUSSEN OTR
Occupational Therapist (Pediatrics)
1317 W GRAND AVE
PORT WASHINGTON, WI 53074
Ozaukee County (262) 284-2261
MRS. TERESA LIN BRAUN MS, CCC-SLP
Speech-Language Pathologist
1317 W GRAND AVE
PORT WASHINGTON, WI 53074
Ozaukee County (262) 284-2261
MS. DEANNE MARIE HAUCH ATC
Specialist/Technologist (Athletic Trainer)
1317 W GRAND AVE
PORT WASHINGTON, WI 53074
Ozaukee County (262) 284-2261
DAVID ARTHUR PETERSON PT
Physical Therapist
1317 W GRAND AVE
PORT WASHINGTON, WI 53074
Ozaukee County (262) 284-2261

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 John Bonavia's NPI number?

The NPI number for John Bonavia is 1497716880. It was assigned to this individual provider in the NPPES registry on March 28, 2006.

Where is John Bonavia located?

John Bonavia practices at 1317 W Grand Ave, Port Washington, WI 53074. The listed phone number is (262) 268-6998.

What is John Bonavia's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for John Bonavia was last updated on June 5, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.