Individual provider Active NPI

Diego Fernando Bonilla, M.D.

  • Internal Medicine Physician
  • Framingham, MA
National Provider Identifier
1093942989
Registry record updated Jan 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
241208 Issued in MA
Practice address
115 Lincoln St
Framingham, MA 01702-6358
Phone
(508) 383-1000
NPI assigned
Jun 17, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 241208 MA Primary

Addresses

Primary practice location

115 Lincoln St
Framingham, MA 01702-6358

Mailing address

1180 Beacon St
Ste 3C
Brookline, MA 02446-3806
Phone (646) 238-2960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20160928000226 FL Practitioner - Critical Care (Intensivists)Practitioner - Pulmonary Disease 4284879859 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Pulmonary Disease
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intensive Care Consortium IncGroup PAC ID 0244269413, 485 clinicians

Practice addresses (Care Compare)

11750 SW 40 St
Miami, FL 33175-3530
Phone (561) 997-0821

20900 Biscayne Blvd
Aventura, FL 33180-1407
Phone (561) 997-0821

Hospital & facility affiliations

  • HCA Florida Kendall Hospital Hospital, Miami, FL, CCN 100209

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
241208MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Intensive Care Consortium Inc CurrentSince Aug 15, 2016 Accepting new patients
Vital Medical Forces of Dover PC Internal Medicine Past Accepting new patients

Locations

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453334400000",
    "number": "1093942989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 BEACON ST",
            "address_2": "STE 3C",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463806",
            "telephone_number": "646-238-2960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 LINCOLN ST",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017026358",
            "telephone_number": "508-383-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "DIEGO",
        "middle_name": "FERNANDO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-17",
        "last_updated": "2016-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "241208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Framingham, MA

Sources for this page

Verify at the official NPI Registry.