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Active NPI 1265541395 Individual Practitioner Male Practitioner

Dr. John Joseph Bonacorsi , MD

Specialist • Bridgeton, MO

Professional Overview & Biography Verified Profile Summary

Dr. John Bonacorsi, MD is a registered healthcare professional specializing in Specialist in Bridgeton, MO. Practice services are available at 12277 DE PAUL DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

12277 De Paul Dr
Ste. 502s

Bridgeton, MO 630442516

Telephone 3142915307
Fax 3142910838
Associated Practice Facility / Clinic
🏢 Multi-Care Medical, Pc Facility NPI 1427056084

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Bridgeton, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 37.3 Yrs
Regional Practice Density
6 Specialists

Practicing in Bridgeton, MO (503 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License MO R5611

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
200165504 (MO)
Commercial Insurance / Payer ID Ptan
001013172 (MO)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
NPI 1063522597

Doctor of Medicine (M.D.)

NPI 1487940672

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active September 14, 2011

NPI status registered as active in NPPES database

📍
Updated Practice Location September 14, 2011

Registered at 12277 DE PAUL DR, STE. 502S, BRIDGETON, MO 630442516 (Tel: 3142915307)

📍
Updated Business Mailing Address September 14, 2011

Registered at 12277 DE PAUL DR, STE. 502S, BRIDGETON, MO 630442516

👤
Provider Name / Credentials Updated September 14, 2011

Recorded as JOHN BONACORSI, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 14, 2011

Specialist (License #R5611 in MO)

🟢
Initial NPI Registration & Enumeration August 30, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1265541395
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 30, 2006
Last Update: September 14, 2011
Sole Proprietor: No

Mailing Address

12277 De Paul Dr, Ste. 502s

Bridgeton, MO 630442516

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.