NPIMap

Individual provider Active NPI

Michael G Bonacum, D.O.

  • Internal Medicine Physician
  • Corydon, IN
National Provider Identifier
1487658761
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
02001396 Issued in IN
Practice address
1263 Hospital Dr NW
Suite 250
Corydon, IN 47112-2172
Phone
(812) 738-8136
Fax
(812) 738-3155
NPI assigned
Jun 2, 2005
Last updated
Jul 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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 02001396 IN Primary

Addresses

Primary practice location

1263 Hospital Dr NW
Suite 250
Corydon, IN 47112-2172

Mailing address

1263 Hospital Dr NW
Suite 250
Corydon, IN 47112-2172
Phone (812) 738-8136

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address RBrown@hcin.cernerdirect.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050915000118 IN Practitioner - Internal MedicinePractitioner - Osteopathic Manipulative Medicine 1153216668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Osteopathic Manipulative Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harrison County HospitalGroup PAC ID 9032007208, 45 clinicians

Practice addresses (Care Compare)

1141 Hospital Dr NW
Corydon, IN 47112-2164
Phone (812) 738-7865

1263 Hospital Dr NW
Corydon, IN 47112-2170

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Harrison County Hospital CurrentSince Mar 1, 1994 Accepting new patients
Harrison County Hospital Internal Medicine CurrentSince Mar 1, 1994 Accepting new patients
Harrison County Hospital Past Accepting new patients
Harrison County Hospital Internal Medicine PastSince Feb 1, 2004 Accepting new patients

Locations

1141 Hospital Dr NW
Corydon, IN 47112
Phone (812) 738-7830

1263 Hospital Dr NW
Ste 170
Corydon, IN 47112
Phone (812) 734-3784

1263 Hospital Dr NW
Ste 250
Corydon, IN 47112
Phone (812) 738-4915

245 Atwood St
Corydon, IN 47112
Phone (812) 734-0912

245 Atwood St
#8
Corydon, IN 47112
Phone (812) 738-8136

245 Atwood St
#G
Corydon, IN 47112
Phone (812) 734-1212

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 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1117670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1487658761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1263 HOSPITAL DR NW",
            "address_2": "SUITE 250",
            "city": "CORYDON",
            "state": "IN",
            "postal_code": "471122172",
            "telephone_number": "812-738-8136",
            "fax_number": "812-738-3155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1263 HOSPITAL DR NW",
            "address_2": "SUITE 250",
            "city": "CORYDON",
            "state": "IN",
            "postal_code": "471122172",
            "telephone_number": "812-738-8136",
            "fax_number": "812-738-3155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONACUM",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-02",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "02001396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "RBrown@hcin.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1263 Hospital Dr NW",
            "address_2": "Suite 250",
            "city": "Corydon",
            "state": "IN",
            "country_code": "US",
            "postal_code": "471122172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corydon, IN

Sources for this page

Verify at the official NPI Registry.