Individual provider Active NPI

Mia Isabella Bonasso, PA-C

  • Medical Physician Assistant
  • Bridgeport, WV
National Provider Identifier
1255036281
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA064426 Issued in PA
Practice address
135 Professional PL
Bridgeport, WV 26330-4509
Phone
(681) 342-3660
NPI assigned
Mar 31, 2023
Last updated
Mar 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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 2721 WV
Medical Physician Assistant 363AM0700X MA064426 PA Primary

Addresses

Primary practice location

135 Professional PL
Bridgeport, WV 26330-4509

Mailing address

135 Professional PL
Bridgeport, WV 26330-4509
Phone (681) 342-3660

Other names 1

  • Mia Isabella Virgili Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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

Enrollment IDStateProvider typePAC IDDetails
I20230619001882 WV Practitioner - Physician Assistant 4183082498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
United Hospital Center IncGroup PAC ID 8123936010, 290 clinicians

Practice addresses (Care Compare)

135 Professional PL
Bridgeport, WV 26330-4509
Phone (681) 342-3660

327 Medical Park Dr
Bridgeport, WV 26330-9006
Phone (681) 342-1842

527 Medical Park Dr
Bridgeport, WV 26330-9009

916 W Main St
Bridgeport, WV 26330-1651
Phone (304) 842-1034

PO Box
Suite 775
Morgantown, WV 26507-0775

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2721WVMDProfessional Counselor
MA064426PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
United Hospital Center, Inc. CurrentSince Jun 12, 2023 Accepting new patients
United Hospital Center Past Accepting new patients

Locations

135 Professional Pl
Bridgeport, WV 26330
Phone (681) 342-3595

327 Medical Park Dr
Bridgeport, WV 26330
Phone (681) 342-1000

916 W Main St
Bridgeport, WV 26330
Phone (304) 842-1034

1 Amalia Dr
Buckhannon, WV 26201
Phone (304) 473-2000

2673 Davisson Run Rd
Ste 303
Clarksburg, WV 26301

Organizations & group practices 2

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1680220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1255036281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 PROFESSIONAL PL",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263304509",
            "telephone_number": "681-342-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 PROFESSIONAL PL",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263304509",
            "telephone_number": "681-342-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONASSO",
        "first_name": "MIA",
        "middle_name": "ISABELLA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-31",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "2721",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA064426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIA",
            "last_name": "VIRGILI",
            "middle_name": "ISABELLA",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bridgeport, WV

Sources for this page

Verify at the official NPI Registry.