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MICHAEL LEONARD BAGNOLI
NPI 1700976719
Dentist - Oral and Maxillofacial Surgery in Lafayette, IN

Active since October 13, 2006Opted out of Medicare · through Oct 20, 2026
2020 UNION STREET, SUITE 200, LAFAYETTE, IN 47904(765) 446-8808(765) 446-9567 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Michael Leonard Bagnoli NPPES

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

MICHAEL LEONARD BAGNOLI (NPI 1700976719) is an individual oral and maxillofacial surgery provider in Lafayette, Indiana, licensed in Indiana (12008541A) and active in the NPI registry since October 2006. He has opted out of Medicare through October 20, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1700976719
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameMICHAEL LEONARD BAGNOLI
Location Address2020 UNION STREET, SUITE 200Lafayette, IN 47904
Mailing Address40 Redwood CourtLafayette, IN 47904 · Fax (765) 446-9567
Phone(765) 446-8808
Fax(765) 446-9567
Sole ProprietorNo
Enumeration DateOctober 13, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1700976719 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in IN · 12008541A
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
2020 UNION STREET, Lafayette, IN 47904
Open in Google Maps ↗

Other Identifiers 1

Medicare ID-Type Unspecified807910AIN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Michael Leonard Bagnoli has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 20, 2014 through October 20, 2026.

Opt-Out Effective DateOctober 20, 2014
Opt-Out In Effect ThroughOctober 20, 2026Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 47904 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$66.48 typical visit price
range $16.93 – $132.22
Typical copayment $16.62 (range $4.23 – $33.05)
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 2

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

ORAL AND MAXILLOFACIAL SURGERY CENTER OF LAFAYETTE
Dentist (Oral and Maxillofacial Surgery)
2020 UNION STREET, SUITE 200
LAFAYETTE, IN 47904
Tippecanoe County (765) 446-8808
DR. JOEL R DRAGOO DDS
Dentist (Oral and Maxillofacial Surgery)
2020 UNION STREET, SUITE 200
LAFAYETTE, IN 47904
Tippecanoe County (765) 446-8808

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 Michael Bagnoli's NPI number?

The NPI number for Michael Bagnoli is 1700976719. It was assigned to this individual provider in the NPPES registry on October 13, 2006.

Where is Michael Bagnoli located?

Michael Bagnoli practices at 2020 Union Street Suite 200, Lafayette, IN 47904. The listed phone number is (765) 446-8808.

What is Michael Bagnoli's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Michael Bagnoli enrolled in Medicare?

No. Michael Bagnoli has opted out of Medicare through October 20, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Michael Bagnoli accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list Michael Bagnoli 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 Michael Bagnoli was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.