Individual provider Active NPI

Benjamin Tuminez Bondoc, PA-C

  • Physician Assistant
  • Kansas City, MO
National Provider Identifier
1154218006
Registry record updated Oct 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2025036081 Issued in MO
Practice address
800 W 47TH St Ste 100
Kansas City, MO 64112-1241
Phone
(816) 216-7054
NPI assigned
Jun 23, 2025
Last updated
Oct 4, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 15-03142 KS
Physician Assistant 363A00000X 2025036081 MO Primary

Addresses

Primary practice location

800 W 47TH St Ste 100
Kansas City, MO 64112-1241

Mailing address

800 W 47TH St Ste 100
Kansas City, MO 64112-1241
Phone (702) 249-3841

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
15-03142KSMDPhysician Assistant
2025036081MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Spine and Joint Centers of America CurrentSince Aug 17, 2025 Accepting new patients

Locations

800 W 47th St
Ste 100
Kansas City, MO 64112
Phone (816) 216-7054

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1750636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759536000000",
    "number": "1154218006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W 47TH ST STE 100",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641121241",
            "telephone_number": "702-249-3841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W 47TH ST STE 100",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641121241",
            "telephone_number": "816-216-7054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONDOC",
        "first_name": "BENJAMIN",
        "middle_name": "TUMINEZ",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-23",
        "last_updated": "2025-10-04",
        "certification_date": "2025-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-03142",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2025036081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.