Individual provider Active NPI

Vincent Anthony Bonanno, MD

  • Internal Medicine Physician
  • Wpafb, OH
National Provider Identifier
1447225735
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35079926 Issued in OH
Practice address
4881 Sugar Maple Dr
Wpafb, OH 45433-5546
Phone
(937) 257-9926
Fax
(937) 257-1529
NPI assigned
Feb 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35079926 OH Primary

Addresses

Primary practice location

4881 Sugar Maple Dr
Wpafb, OH 45433-5546

Mailing address

4881 Sugar Maple Dr
Wpafb, OH 45433-5546
Phone (937) 257-9926

Other identifiers 1

IdentifierTypeStateIssuer
2304689MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040909001471 OH Practitioner - Internal Medicine 2365418340 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of North Carolina at Chapel Hill School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mvhe IncGroup PAC ID 9537066584, 399 clinicians

Practice addresses (Care Compare)

909 E 2ND St
Franklin, OH 45005-1700
Phone (937) 743-5965

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35079926OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mvhe, Inc Internal Medicine CurrentSince Oct 20, 2025 Accepting new patients
Mvhe Inc Internal Medicine CurrentSince Oct 20, 2025 Accepting new patients
Mvhe Inc Internal Medicine Current Accepting new patients
Vpa PC Internal Medicine Past Accepting new patients

Locations

2451 Wayne Ave
Dayton, OH 45420
Phone (937) 252-1831

909 E 2nd St
Franklin, OH 45005
Phone (937) 746-8357

Organizations & group practices 4

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 2

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": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447225735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4881 SUGAR MAPLE DR",
            "city": "WPAFB",
            "state": "OH",
            "postal_code": "454335546",
            "telephone_number": "937-257-9926",
            "fax_number": "937-257-1529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4881 SUGAR MAPLE DR",
            "city": "WPAFB",
            "state": "OH",
            "postal_code": "454335546",
            "telephone_number": "937-257-9926",
            "fax_number": "937-257-1529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONANNO",
        "first_name": "VINCENT",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35079926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2304689",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wpafb, OH

Sources for this page

Verify at the official NPI Registry.