Individual provider

Matthew Bonaventure, P.A-C

Medical Physician Assistant Physician Assistant Medicare enrolled

Matthew Bonaventure, P.A-C is a Medical Physician Assistant in Fuquay Varina, NC, registered under NPI 1104182195. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty. NPPES records them as a sole proprietor, meaning the practice is not incorporated as a separate legal entity.

Getting there

The practice address on file is 231 N JUDD PKWY NE, Fuquay Varina, NC 27526. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

231 N JUDD PKWY NE, Fuquay Varina, NC 27526 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
0010-13048 NC Medical Physician Assistant primary
0010-13048 NC Physician Assistant
016546 NY Medical Physician Assistant

Licences are recorded in 2 states: NC, NY. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.

Medicare (PECOS)
Status
Approved
Provider type
Practitioner - Physician Assistant
PAC ID
0648503946

Medicare enrolment is recorded as approved under the provider type Practitioner - Physician Assistant. This means the provider is enrolled to bill Medicare, though it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

Licensed in 2 states

This provider holds licences in 2 states: North Carolina and New York. The practice address on file is in Fuquay Varina, NC, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.

NC North Carolina practice address
Licence
0010-13048
Specialty
Medical Physician Assistant
Verify with the NC board →
NY New York
Licence
016546
Specialty
Medical Physician Assistant
Verify with the NY board →

Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.

What Medical covers

Definition to come... NUCC Health Care Provider Taxonomy, code 363AM0700X
Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Medical

All registered taxonomy codes

This provider registers 3 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
363AM0700X Medical Physician Assistant Medical 0010-13048 NC primary
363A00000X Physician Assistant 0010-13048 NC
363AM0700X Medical Physician Assistant Medical 016546 NY

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1104182195 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateApr 4, 2012
Last updatedApr 15, 2024
StatusActive
Sole proprietorYes
CredentialP.A-C
Practice address 231 N JUDD PKWY NE
Fuquay Varina, NC 27526
(919) 235-6560
Mailing address 8701 FORESTER LN
Apex, NC 27539
This record was updated on Apr 15, 2024, which is recent enough that the contact details are likely still accurate.

Number check

1104182195 passes the NPI check digit test The final digit 5 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 1 0 4 1 8 2 1 9
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 1 0 4 2 8 4 1 9

Sum = 55 · next multiple of 10 = 60 · check digit = 5 · actual last digit = 5

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1104182195?
NPI 1104182195 is the National Provider Identifier assigned to Matthew Bonaventure, P.A-C in Fuquay Varina, NC. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Medical cover?
Definition to come...
How do I contact Matthew Bonaventure, P.A-C?
The phone number on file with NPPES is (919) 235-6560, last updated Apr 15, 2024. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does Matthew Bonaventure, P.A-C accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1104182195 a valid number?
Yes. 1104182195 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.