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

Mr. Ronald August Bonaventura Jr.

Individual provider Family Nurse Practitioner · NPI 1063880573

Mr. Ronald August Bonaventura Jr. is a Nurse Practitioner in Saint Clair Shores, Michigan. Qualified in 2015, 11 years ago. Practices with Henry Ford Health Macomb Oakland Hospital, a 146-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
11
Licensed in
MI
In the registry since
2015
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Practice location Address checks out

22432 Harper Lake Ave
Saint Clair Shores, MI 48080-4041
Phone: (586) 557-8398
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 4704286546 (MI)

Record details

NPI number1063880573
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedSeptember 14, 2015
Last updated in NPPESSeptember 14, 2015

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Henry Ford Health Macomb Oakland Hospital — 146 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Saint Clair Shores