Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Michael T Bontekoe, MS, PA-C

Individual provider Medical Physician Assistant · NPI 1124120902

Michael T Bontekoe, MS, PA-C is a Physician Assistant in Beverly Hills, California. Qualified in 2001, 25 years ago. Practices with Roxbury Dermatology and Multispecialty Practice Inc, a 2-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
25
Licensed in
CA
In the registry since
2006
Specialties on file
2
What do these letters mean?
MS — Master of Science
A graduate science degree.
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

450 N Roxbury Dr Ste 400
Beverly Hills, CA 90210-4218
Phone: (243) 941-6104
Fax: (424) 394-1628
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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 PA16231 (CA)
Dermatology Physician Taxonomy 207N00000X · Licence PA16231 (CA)

Record details

NPI number1124120902
Entity typeIndividual (Type 1)
GenderMale
Credentials MS , PA-C
Sole proprietorYes
NPI enumeratedSeptember 2, 2006
Last updated in NPPESNovember 2, 2020
Certification dateOctober 30, 2020

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Group practice Roxbury Dermatology And Multispecialty Practice Inc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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