Gabriel L Bonilla, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

32912 Issued in AZ

Practice address

2526 W Rancho Laredo Dr
Phoenix, AZ 85085-7168

Phone

(928) 600-6762

NPI assigned

Feb 6, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pain Management

Education

University of Puerto Rico School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Active Life Physical Medicine and Pain Center PLLCGroup PAC ID 0941350953, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CBAIAA
• FHIR API: https://api.platform.athenahealth.com/3522/brand/1/csg/21/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Active Life Physical Medicine and Pain Center, PLLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Surprise, AZ
  • NPI 1811130016
  Medicare reassignment Care Compare group NPD
• Bella Healthcare LLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Tempe, AZ
  • NPI 1386065183
  Medicare reassignment NPD
• Rhad Health Care LLC

  • Family Medicine Physician
  • Peoria, AZ
  • NPI 1780339721
  Medicare reassignment NPD
• Surgepay LLC

  • Interventional Pain Medicine Physician
  • Scottsdale, AZ
  • NPI 1174182596
  NPD Authorized official
• Southwest Comprehensive Pain Management LLC

  • Pain Clinic/Center
  • Phoenix, AZ
  • NPI 1316114663
  NPD (past) Authorized official
• Arthur H Schurgin DO PC

  • Pain Medicine (Anesthesiology) Physician
  • Scottsdale, AZ
  • NPI 1306961925
  NPD (past)
• Next Level Facility LLC

  • Interventional Pain Medicine Physician
  • Phoenix, AZ
  • NPI 1558135756
  NPD (past)
• Northern Arizona Orthopaedics, LTD.

  • Multi-Specialty Clinic/Center
  • Flagstaff, AZ
  • NPI 1164495503
  NPD (past)
• Premier Physicians Group, PLLC

  • Pain Clinic/Center
  • Mesa, AZ
  • NPI 1568643047

  Physical Medicine & Rehabilitation

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588291200000",
    "number": "1023080744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2526 W RANCHO LAREDO DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850857168",
            "telephone_number": "928-600-6762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2526 W RANCHO LAREDO DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850857168",
            "telephone_number": "928-600-6762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "GABRIEL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2020-05-01",
        "certification_date": "2020-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AZ",
            "license": "32912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "862913",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Bonfiglio, PA-C
• Sara Bonham
• Emmanuel Bonilla-Segura, PT, DPT
• Adriana A Bonilla
• Briauna Mae Bonilla
• Pamela Ann Bonilla, LPC-21205
• Christopher L Bonin, D.C.
• Bonita Women'S Care, P.L.C.
• Andrea N Bonk, MS, CCC-SLP
• Mary Kristine Bonn, MD

• Physical Medicine & Rehabilitation Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Physical Medicine & Rehabilitation Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.