Lisa Camille Bonin, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9114636 Issued in FL

Practice address

1700 E Venice Ave
Venice, FL 34292-3190

Phone

(941) 483-9760

Fax

(941) 483-9775

NPI assigned

Jun 4, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: lisa.bonin.1@4290.direct.athenahealth.com

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.

• Millennium Physician Group LLC

  • Family Medicine Physician
  • Fort Myers, FL
  • NPI 1811122880
  Medicare reassignment Care Compare group NPD
• Millennium Physician Group LLC

  • Family Medicine Physician
  • Brooksville, FL
  • NPI 1073131702
  NPD
• Atlantic Professional Services of New Jersey, P.a.

  • Physician Assistant
  • Stratford, NJ
  • NPI 1932145182
  NPD (past)
• Barnabas Health Medical Group, PC

  • Specialist
  • West Orange, NJ
  • NPI 1447206420
  NPD (past)
• Emergency Medical Associates CHS LLC

  • Emergency Medicine Physician
  • Trenton, NJ
  • NPI 1023055993
  NPD (past)
• Emergency Medical Associates of New Jersey PA

  • Emergency Medicine Physician
  • Long Branch, NJ
  • NPI 1841456068
  NPD (past)
• Orthopaedic Institute of Central Jersey

  • Orthopaedic Surgery Physician
  • Manasquan, NJ
  • NPI 1043286735
  NPD (past)
• Orthopaedic Institute of Central Jersey

  • Orthopaedic Surgery Physician
  • Red Bank, NJ
  • NPI 1598263360
  NPD (past)
• Tidal Emergency Physicians LLC

  • Emergency Medicine Physician
  • Neptune, NJ
  • NPI 1649222407
  NPD (past)

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1235177601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E VENICE AVE",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342923190",
            "telephone_number": "941-483-9760",
            "fax_number": "941-483-9775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONIN",
        "first_name": "LISA",
        "middle_name": "CAMILLE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-04",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9114636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cameron Jennay Boles, LMHC
• Robert Bolton, DDS MS
• Jennifer Michelle Bomalaski
• Matthew J Bonanno, MD
• Kirsten Bond
• Jeremy Bonjorno, D.P.M.
• Chandana Bopitiya, M.D.
• Samantha Hope Bouie, APRN
• Joann Bova
• Tammy Bowdle, MSN, APRN, PMHNP-BC

• Physician Assistant in Venice, FL
• Providers in Venice, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.