Individual provider Active NPI

Ileana Rivera Bonilla, MD

  • Pediatrics Physician
  • Bayamon, PR
National Provider Identifier
1144206871
Registry record updated Nov 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
10742 Issued in PR
Practice address
Villas de San Agustin
Calle 2 a 13
Bayamon, PR 00959
Phone
(787) 786-5844
NPI assigned
Dec 15, 2005
Last updated
Nov 17, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 10742 PR Primary

Addresses

Primary practice location

Villas de San Agustin
Calle 2 a 13
Bayamon, PR 00959

Mailing address

A3 Ave Perez Andino
Urb Villas de Rio Grande
Rio Grande, PR 00745
Phone (787) 888-2302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10742PRMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Servicios Medicos Universitarios Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: uprirb@yourcarecommunity.org

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479340800000",
    "number": "1144206871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "A3 AVE PEREZ ANDINO",
            "address_2": "URB VILLAS DE RIO GRANDE",
            "city": "RIO GRANDE",
            "state": "PR",
            "postal_code": "00745",
            "telephone_number": "787-888-2302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "VILLAS DE SAN AGUSTIN",
            "address_2": "CALLE 2 A 13",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00959",
            "telephone_number": "787-786-5844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA BONILLA",
        "first_name": "ILEANA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-15",
        "last_updated": "2016-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PR",
            "license": "10742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.