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

Matthew Eugene Bonaventure, PA-C

Individual provider Physician Assistant · NPI 1104182195

Matthew Eugene Bonaventure, PA-C is a Physician Assistant in Fuquay Varina, North Carolina. Qualified in 2011, 15 years ago. Practices with Active Life Health of Cary PLLC, a 5-clinician group and accepts Medicare assignment. Licensed in North Carolina and New York.

Years since qualifying
15
Licensed in
NC, NY
In the registry since
2012
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

231 N Judd Pkwy NE
Fuquay Varina, NC 27526-2694
Phone: (919) 235-6560
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 0010-13048 (NC)
Physician Assistant Taxonomy 363A00000X · Licence 0010-13048 (NC)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 016546 (NY)

Record details

NPI number1104182195
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedApril 4, 2012
Last updated in NPPESApril 15, 2024
Certification dateApril 15, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Active Life Health Of Cary Pllc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Fuquay Varina