Daniel Ryan Bonifield, D.O.
Individual provider Active NPI Vascular & Interventional Radiology Physician · Casper, WY
NPI 1942513288 · NPPES record last updated Jun 17, 2024
Key facts
- NPI
- 1942513288
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Vascular & Interventional Radiology Physician 2085R0204X
- License
- 14070A (WY)
- Practice address
- 419 S Washington St Ste 101
Casper, WY 82601-2951 - Phone
- (307) 265-1620
- Fax
- (307) 237-1074
- NPI assigned
- Jul 15, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Diagnostic Radiology
- Education
- Touro Un Col of Osteopathic Medicine, Henderson, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Casper Medical Imaging PC
Outpatient Radiology LLC
Practice addresses (Care Compare)
419 S Washington St
Suite 101
Casper, WY 82601-2951
Phone (307) 265-1620
820 W 42ND St
Suite 1500
Scottsbluff, NE 69361-5017
Phone (307) 265-1620
Hospital & facility affiliations
- Banner Wyoming Medical Center
- Campbell County Health
- Cody Regional Health
- Fallon Medical Complex Hospital
- Community Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 47.53 of 100
- Quality
- 30
- Improvement activities
- 20
- Cost
- 57.47
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Leg revascularization (restoring blood flow) | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WY, NE
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221122002191 | WY | Practitioner - Diagnostic Radiology |
4587964895 | Reassigns benefits to 3 organizations |
| I20240601000160 | NE | Practitioner - Diagnostic Radiology | 4587964895 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DR.0065791 | CO | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Campbell County Hospital District | Current |
Accepting new patients | |
| Campbell County Hospital District | Current |
Accepting new patients | |
| Casper Medical Imaging, P.C. | Diagnostic Radiology | Current |
Accepting new patients |
| Outpatient Radiology LLC | Diagnostic Radiology | Current |
Accepting new patients |
| Ark-la-Tex Diagnostics, Inc. | Current |
Accepting new patients | |
| Campbell County Hospital District | Current | Accepting new patients | |
| Campbell County Hospital District | Current | Accepting new patients | |
| Second Avenue MRI LLC | Diagnostic Radiology | Past |
Accepting new patients |
Locations
5413 Jackson Street Ext
Alexandria, LA 71303
Phone (318) 442-8399
820 W 42nd St
Ste 150
Scottsbluff, NE 69361
820 W 42nd St
Ste 1500
Scottsbluff, NE 69361
1233 E 2nd St
Casper, WY 82601
Phone (307) 577-2171
6600 E 2nd St
Ste E
Casper, WY 82609
Phone (307) 232-5012
419 S Washington St
Ste 101
Casper, WY 82601
Phone (307) 232-5037
1207 E 2nd St
Casper, WY 82601
501 S Burma Ave
Gillette, WY 82716
Phone (307) 682-8811
Interoperability endpoints
- daniel.bonifield.1@29134.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | DR.0065791 | CO | |
| Diagnostic Radiology Physician | 2085R0202X | 14070A | WY | |
| Diagnostic Radiology Physician | 2085R0202X | COPS126 | NE | |
| Vascular & Interventional Radiology Physician | 2085R0204X | 14070A | WY | Yes |
Addresses
Primary practice location
419 S Washington St Ste 101
Casper, WY 82601-2951
Mailing address
419 S Washington St Ste 101
Casper, WY 82601-2991
Phone (307) 265-1620
Other providers in Casper, WY
- Bokbh LLC
- Brian Keith Boles
- Jeneil Boles
- Mary C Boltz
- Anna Jean Bond
- Angela Lee Booth
- Travis Bopp
- Makala Raye Boren
- Bottom Half, LLC
- Michael Raymond Boulter
All providers in Casper, WY · Vascular & Interventional Radiology Physician in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.