Individual provider Active NPI

Timothy Alan Bonsack, M.D.

  • Diagnostic Radiology Physician
  • Tampa, FL
National Provider Identifier
1710952155
Registry record updated Apr 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME68441 Issued in FL
Practice address
4516 N Armenia Ave
Tampa, FL 33603-2732
Phone
(813) 348-6951
Fax
(813) 348-6999
NPI assigned
Feb 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME68441 FL
Diagnostic Radiology Physician 2085R0202X ME68441 FL Primary

Addresses

Primary practice location

4516 N Armenia Ave
Tampa, FL 33603-2732

Mailing address

PO Box 403444
Atlanta, GA 30384-3444
Phone (813) 348-6951

Other identifiers 2

IdentifierTypeStateIssuer
378134800MedicaidFL
300063105OtherFLRR MCR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050525000966 FL Practitioner - Diagnostic Radiology 6103868575 Reassigns benefits to 4 organizations
I20130620000177 GA Practitioner - Diagnostic Radiology 6103868575 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Emory University School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Diagnostic Center LLCGroup PAC ID 3779484928, 89 clinicians
Radiology Imaging Associates LLCGroup PAC ID 2466342803, 182 clinicians
Baycare Outpatient Imaging LLCGroup PAC ID 3577804087, 90 clinicians
Stern Drake Isbell and Associates PAGroup PAC ID 3779480835, 57 clinicians

Practice addresses (Care Compare)

10141 Big Bend Rd
Riverview, FL 33578-7419
Phone (813) 302-8925

1041 Dunlawon Ave
Port Orange, FL 32127-7968
Phone (386) 274-7118

1490 SE Magnolia Ext
Ocala, FL 34471-4443
Phone (352) 732-7400

2470 Bloomingdale Ave
Suite 115
Valrico, FL 33596-6403
Phone (727) 281-9390

3001 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6307
Phone (813) 348-6915

3001 W MLK Blvd
Tampa, FL 33607-6307
Phone (813) 870-4000

3003 W Dr MLK Blvd
Tampa, FL 33607-6307
Phone (813) 870-4826

3030 W MLK Blvd
Tampa, FL 33607-6308
Phone (813) 879-4730

3202 N Park Rd
Plant City, FL 33563-2026
Phone (813) 757-1200

4211 Van Dyke Rd
Lutz, FL 33558-8005
Phone (813) 443-7000

4516 N Armenia Ave
Tampa, FL 33603-2732
Phone (813) 348-6900

6901 Simmons Loop
Riverview, FL 33578-9498
Phone (813) 302-8000

Hospital & facility affiliations

  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075
  • South Florida Baptist Hospital Hospital, Plant City, FL, CCN 100132

Merit-based Incentive Payment System (MIPS)

Final score
71.5 of 100Reported as group
Quality
66.47
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
99.99 of 100Reported as group
Quality
100
Improvement activities
40
Cost
79.08

Merit-based Incentive Payment System (MIPS)

Final score
87.68 of 100Reported as group
Quality
85.5
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME68441FLMDSpecialist

Practice roles (8 of 10)

OrganizationSpecialtyStatusNew patients
St Joseph'S Diagnostic Center LLC Diagnostic Radiology CurrentSince Jul 27, 2014 Accepting new patients
Baycare Outpatient Imaging LLC Diagnostic Radiology Current Accepting new patients
Baycare Outpatient Imaging LLC Diagnostic Radiology CurrentSince Apr 6, 2019 Accepting new patients
Stern, Drake, Isbell & Associates, PA Specialist CurrentSince Jul 1, 1995 Accepting new patients
Radiology Imaging Associates, LLC Diagnostic Radiology CurrentSince Jan 1, 2026 Accepting new patients
St Joseph'S Diagnostic Center LLC Diagnostic Radiology CurrentSince Jul 27, 2014 Accepting new patients
Baycare Outpatient Imaging LLC Diagnostic Radiology CurrentSince Apr 6, 2019 Accepting new patients
St Josephs Diagnostic Center LLC Diagnostic Radiology Current Accepting new patients

Locations

577 N Williamson Blvd
Daytona Beach, FL 32114

18600 Fernview St
Ste 101
Land O Lakes, FL 34638
Phone (813) 692-8010

4211 Van Dyke Rd
Lutz, FL 33558
Phone (813) 265-6300

1500 SW 1st Ave
Ocala, FL 34471
Phone (352) 351-7500

1490 SE Magnolia Ext
Ocala, FL 34471
Phone (352) 512-9703

3202 N Park Rd
Plant City, FL 33563
Phone (813) 727-1200

1041 Dunlawton Ave
Pt Orange, FL 32127
Phone (386) 322-4700

6901 Simmons Loop
Riverview, FL 33578
Phone (813) 302-8000

8425 Northcliffe Blvd
Spring Hill, FL 34606
Phone (352) 606-2727

4516 N Armenia Ave
Tampa, FL 33603
Phone (813) 348-6900

3030 W Mlk Blvd
Tampa, FL 33607
Phone (813) 870-4000

3001 W Mlk Blvd
Tampa, FL 33607
Phone (813) 361-6778

3003 W Mlk Blvd
Tampa, FL 33607
Phone (813) 357-0630

2470 Bloomingdale Ave
Ste 115
Valrico, FL 33596
Phone (727) 281-9479

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 9

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.

Hospital & facility affiliations 3

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": "1270080000000",
    "number": "1710952155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 403444",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303843444",
            "telephone_number": "813-348-6951",
            "fax_number": "813-348-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4516 N ARMENIA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336032732",
            "telephone_number": "813-348-6951",
            "fax_number": "813-348-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONSACK",
        "first_name": "TIMOTHY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2010-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME68441",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME68441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "378134800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "300063105",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.