Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Charles Edward Bonfanti, PA

Individual provider Physician Assistant · NPI 1295792570

Charles Edward Bonfanti, PA is a Physician Assistant in Taos, New Mexico. Qualified in 1975, 51 years ago. Practices with Family Practice Associates of Taos, a 2-clinician group and accepts Medicare assignment. Licensed in New Mexico.

Years since qualifying
51
Licensed in
NM
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

630 Paseo Del Pueblo Sur Ste 150
Taos, NM 87571-6070
Phone: (575) 758-3005
Fax: (575) 758-7010
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 75-PA002 (NM)

Record details

NPI number1295792570
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedApril 28, 2006
Last updated in NPPESFebruary 3, 2017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1975 (51 years in practice)
Group practice Family Practice Associates Of Taos — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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