DR. BONIFASIYO K. SSENNYAMANTONO MD
NPI 1902813678
Internal Medicine - Cardiovascular Disease in Avondale, AZ

Active since August 02, 2006PECOS EnrolledAccepts Medicare Assignment
10815 W MCDOWELL RD, SUITE 202, AVONDALE, AZ 85392(623) 433-0202(623) 433-0206 Get Directions Write a Review

NPPES record last updated: July 31, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 31, 2024, Apr 22, 2019 (2 updates tracked since 2019).

About Dr. Bonifasiyo K. Ssennyamantono Md NPPES

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

DR. BONIFASIYO K. SSENNYAMANTONO MD (NPI 1902813678) is an individual cardiovascular disease provider in Avondale, Arizona, licensed in Arizona (35788) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS and is a graduate of Columbia University College Of Physicians And Surgeons (2000).

NPPES Registry Identity

NPI1902813678
Entity TypeIndividualMale
Primary Taxonomy207RC0000X
Provider Legal NameDR. BONIFASIYO K. SSENNYAMANTONOCredential: MD
Location Address10815 W MCDOWELL RD, SUITE 202Avondale, AZ 85392-5007
Mailing Address3815 E Bell Rd Ste 4500Phoenix, AZ 85032-2171 · (602) 633-3848 · Fax (602) 633-3841
Fax(623) 433-0206
Sole ProprietorNo
Medical School CMSColumbia University College Of Physicians And SurgeonsGraduated 2000
Enumeration DateAugust 2, 2006
Last NPPES UpdateJuly 31, 20242 updates tracked since enumeration
NPPES CertifiedJuly 31, 2024
NPI 1902813678 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
License Licensed in AZ · 35788
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
10815 W MCDOWELL RD, Avondale, AZ 85392

Other Identifiers 1

Medicaid129134AZ

Accepted 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

Dr. Bonifasiyo K. Ssennyamantono Md 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 ID4082611280
PECOS Enrollment IDI20061101000157
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.

Areas of Expertise CMS Part B claims 29

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
636 services370 patients
Injection, regadenoson, 0.1 mg J2785
Regadenoson injection, 0.1 mg, is a medication used to help visualize the heart during a stress test. It works by increasing blood flow in the arteries of the heart. It's injected into a vein and is generally well-tolerated.
457 services115 patients
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306
This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
318 services313 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
281 services220 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
259 services250 patients
Technetium tc-99m sestamibi, diagnostic, per study dose A9500
Technetium Tc-99m Sestamibi is a diagnostic test used to create images of your heart or breast tissues. It involves a safe radioactive substance injection that helps doctors to detect any abnormalities or changes in these tissues.
256 services128 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85392 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
$127.71 typical visit price
range $55.44 – $168.60
Typical copayment $31.92 (range $13.86 – $42.15)
Most-billed visit code 99204
Established Patient
$69.24 typical visit price
range $17.72 – $137.41
Typical copayment $17.31 (range $4.43 – $34.35)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
0%462 patients1/55-star benchmark: 92%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
6%966 patients1/55-star benchmark: 85%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
81%420 patients4/55-star benchmark: 99%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
97%3,234 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
95%1,938 patients4/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
97%754 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
6%1,676 patients1/55-star benchmark: 99%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
20%641 patients1/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
18%1,664 patients1/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
12%1,170 patients1/55-star benchmark: 88%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
54%1,676 patients3/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
3%1,676 patients1/55-star benchmark: 59%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
Percentage of the following patients - all considered at high risk of cardiovascular events - who were prescribed or were on statin therapy during the measurement period: - Adults aged >= 21 years who were previously diagnosed with or currently have an active…
75%858 patients4/55-star benchmark: 89%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 1% · 641 patients
5%641 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 19

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

Physical Medicine & Rehabilitation
10815 W MCDOWELL RD
AVONDALE, AZ 85392
Anesthesiology
10815 W MCDOWELL RD
AVONDALE, AZ 85392
Family Medicine
10815 W MCDOWELL RD, 201
AVONDALE, AZ 85392
Internal Medicine (Cardiovascular Disease)
10815 W MCDOWELL RD, SUITE 202
AVONDALE, AZ 85392
Internal Medicine (Cardiovascular Disease)
10815 W MCDOWELL RD, SUITE 202
AVONDALE, AZ 85392
Internal Medicine (Cardiovascular Disease)
10815 W MCDOWELL RD, SUITE 202
AVONDALE, AZ 85392
Clinic/Center (Ambulatory Surgical)
10815 W MCDOWELL RD, STE 304
AVONDALE, AZ 85392
Orthopaedic Surgery
10815 W MCDOWELL RD, SUITE 303
AVONDALE, AZ 85392

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 Bonifasiyo Ssennyamantono's NPI number?

The NPI number for Bonifasiyo Ssennyamantono is 1902813678. It was assigned to this individual provider in the NPPES registry on August 2, 2006.

Where is Bonifasiyo Ssennyamantono located?

Bonifasiyo Ssennyamantono practices at 10815 W Mcdowell Rd Suite 202, Avondale, AZ 85392. The listed phone number is (623) 433-0202.

What is Bonifasiyo Ssennyamantono's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Bonifasiyo Ssennyamantono enrolled in Medicare?

Yes. Bonifasiyo Ssennyamantono is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Bonifasiyo Ssennyamantono accept?

Health plans from Ambetter from Arizona Complete Health and Blue Cross Blue Shield of Arizona list Bonifasiyo Ssennyamantono 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 Bonifasiyo Ssennyamantono was last updated on July 31, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.