Nicole Bonanni, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C0005565 Issued in MD

Practice address

180 Admiral Cochrane Dr Ste 430
Annapolis, MD 21401-8405

Phone

(410) 339-0760

Fax

(410) 263-7482

NPI assigned

Oct 28, 2014

Sex

Female

Sole proprietor

No

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 MD

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anne Arundel Dermatology PAGroup PAC ID 6608761960, 126 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

95.75 of 100Reported as group

Promoting interoperability

95

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nbonanni@aadermaffiliates.emadirect.md

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.

• Anne Arundel Dermatology LLC

  • Dermatology Physician
  • Annapolis, MD
  • NPI 1063481703
  Medicare reassignment Care Compare group
• St. Paul Place Specialists, Inc.

  • Orthopaedic Foot and Ankle Surgery Physician
  • Baltimore, MD
  • NPI 1871549196
  Medicare reassignment
• St Paul Place Specialists Inc

  • Diagnostic Radiology Physician
  • Baltimore, MD
  • NPI 1497707681
  NPD
• St Paul Place Specialists, Inc.

  • Orthopaedic Surgery Physician
  • Baltimore, MD
  • NPI 1851405187

  Physician Assistant

  NPD
• Anne Arundel Dermatology, PA

  • Dermatology Physician
  • Annapolis, MD
  • NPI 1285468231
  NPD (past)
• Anne Arundel Dermatology, PA

  • Dermatology Physician
  • Prince Frederick, MD
  • NPI 1568292282
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1414454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785369600000",
    "number": "1235534645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23329",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100873329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 ADMIRAL COCHRANE DR STE 430",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214018405",
            "telephone_number": "410-339-0760",
            "fax_number": "410-263-7482"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7671 Quarterfield Rd Ste 200B",
            "address_purpose": "LOCATION",
            "city": "Glen Burnie",
            "state": "MD",
            "postal_code": "210614407",
            "country_code": "US",
            "telephone_number": "441-351-3376",
            "fax_number": "410-582-9155",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "810 Landmark Dr Ste 120-122",
            "address_purpose": "LOCATION",
            "city": "Glen Burnie",
            "state": "MD",
            "postal_code": "210614987",
            "country_code": "US",
            "telephone_number": "443-351-3376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4 Caulk Ln Ste B",
            "address_purpose": "LOCATION",
            "city": "Easton",
            "state": "MD",
            "postal_code": "216013808",
            "country_code": "US",
            "telephone_number": "410-822-8223",
            "fax_number": "410-822-1423",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7671 Quarterfield Rd Ste 200A",
            "address_purpose": "LOCATION",
            "city": "Glen Burnie",
            "state": "MD",
            "postal_code": "210614407",
            "country_code": "US",
            "telephone_number": "443-351-3376",
            "fax_number": "410-582-9155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONANNI",
        "first_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-28",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0005565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bruce J Bolten, MD
• Janice Yerman Bolten, R.N.
• Emma Taylor Bolyard, MD
• Michelle Maureen Bomyea, PT, DPT
• Francis Anthony Bonadio Jr., PH.D.
• Lindsay Bonaparte
• Thomas C. Bonfiglio, D.D.S.
• Shelby Northup Bonish, AUD
• Victor Bonney, RDCS
• Theresa Rugalla Booker, CRNP

• Physician Assistant in Annapolis, MD
• Providers in Annapolis, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2026; 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.