Active NPI
Timothy John Bonatus, MD
- Orthopaedic Surgery Physician
- Flagstaff, AZ
National Provider Identifier
1023089646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 2691
- Practice address
- 1485 N Turquoise Dr
Ste 200
Flagstaff, AZ 86001-1398 - Phone
- (928) 774-7757
- Fax
- (928) 226-3071
- NPI assigned
- Jan 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 2691 | AZ | Primary |
Addresses
Primary practice location
1485 N Turquoise Dr
Ste 200
Flagstaff, AZ 86001-1398
Mailing address
1485 N Turquoise Drive
Flagstaff, AZ 86001
Phone (928) 774-7757
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 137952 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2691 | AZ | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Flagstaff Medical Center | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Acute Care Hospital
- Flagstaff, AZ
- NPI 1780635078
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555459200000",
"number": "1023089646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1485 N TURQUOISE DRIVE",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "86001",
"telephone_number": "928-774-7757",
"fax_number": "928-226-3071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1485 N TURQUOISE DR",
"address_2": "STE 200",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860011398",
"telephone_number": "928-774-7757",
"fax_number": "928-226-3071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONATUS",
"first_name": "TIMOTHY",
"middle_name": "JOHN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-31",
"last_updated": "2019-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "AZ",
"license": "2691",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "137952",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Flagstaff, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.