Charles Bonanno, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

148408 Issued in FL

Practice address

2685 Executive Park Dr Ste 5
Weston, FL 33331-3651

Phone

(954) 590-0556

NPI assigned

May 18, 2018

Last updated

Sep 14, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

NephrologyAlso: Internal Medicine

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Compass Nephrology Care, PLLCGroup PAC ID 7214393255, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pure Life Renal of Miramar Dialysis facility, Miramar, FL, CCN 682711
• Memorial Hospital West Hospital, Pembroke Pines, FL, CCN 100281
• Memorial Regional Hospital Hospital, Hollywood, FL, CCN 100038
• Memorial Hospital Miramar Hospital, Miramar, FL, CCN 100285
• Memorial Hospital Pembroke Hospital, Pembroke Pines, FL, CCN 100230

Merit-based Incentive Payment System (MIPS)

Final score

91.01 of 100Reported as group

Quality

72.99

Promoting interoperability

82

Improvement activities

40

Cost

78.71

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charles.bonanno@compassnephro.eclinicaldirectplus.com
• FHIR API: https://fhir4.healow.com/fhir/r4/CIBBDD/Endpoint/CIBBDD

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.

• Compass Nephrology Care, PLLC

  • Nephrology Physician
  • Weston, FL
  • NPI 1053008318
  Medicare reassignment Care Compare group NPD Authorized official
• Rose Infusion Services Inc

  dba Rose Pharmacy

  • Infusion Therapy Clinic/Center
  • Pembroke Pines, FL
  • NPI 1750195137
  Medicare reassignment NPD
• Townsend Dialysis LLC

  dba Plantation Home Training

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Plantation, FL
  • NPI 1316280068
  NPD (past)

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

• Pure Life Renal of Miramar, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Miramar, FL
  • NPI 1225671118

  Dialysis facility

  Care Compare affiliation Name & address match
• South Broward Hospital District

  dba Memorial Hospital Pembroke

  • General Acute Care Hospital
  • Pembroke Pines, FL
  • NPI 1063495836
  Care Compare affiliation
• South Broward Hospital District

  dba Memorial Hospital West

  • General Acute Care Hospital
  • Pembroke Pines, FL
  • NPI 1134102080
  Care Compare affiliation
• South Broward Hospital District

  dba Memorial Hospital Miramar

  • General Acute Care Hospital
  • Miramar, FL
  • NPI 1326021197
  Care Compare affiliation
• South Broward Hospital District

  dba Memorial Regional Hospital

  • General Acute Care Hospital
  • Hollywood, FL
  • NPI 1780667923
  Care Compare affiliation

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

{
    "created_epoch": "1526601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1447740014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2685 EXECUTIVE PARK DR STE 5",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333313651",
            "telephone_number": "954-590-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2685 EXECUTIVE PARK DR STE 5",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333313651",
            "telephone_number": "954-590-0556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1611 NW 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331361005",
            "country_code": "US",
            "telephone_number": "305-243-6884",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "703 N Flamingo Rd",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330281014",
            "country_code": "US",
            "telephone_number": "954-844-4491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONANNO",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-18",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME148408",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "148408",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME148408",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elad Boaz, MD
• Ajanae Bogle
• Pedro G Bolanos Sr.
• Ashley Lauren Bolling, APRN
• Elise Bolski, D.D.S.
• Ernesto Bonilla, M.D.
• Javier E Bonilla, DDS
• Merelyn Bonilla
• Richard H Boozer, PSY.D.
• Andres Borja Alvarez, MD

• Nephrology Physician in Weston, FL
• Providers in Weston, FL by specialty
• Nephrology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; 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.