Juan Samuel Ignacio Bonilla-Perez, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

292251 Issued in NY

Practice address

1114 Liberty Ave
Brooklyn, NY 11208-2922

Phone

(718) 765-6058

Fax

(347) 808-4895

NPI assigned

Jun 11, 2007

Last updated

Jul 29, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• HPM Foundation Inc

  • Federally Qualified Health Center (FQHC)
  • San Juan, PR
  • NPI 1316167661
  Medicare reassignment
• Oak Street Health of New York Medical Group PC

  • Primary Care Clinic/Center
  • Brooklyn, NY
  • NPI 1780209445

  Family Medicine

  NPD
• HPM Foundation Inc

  • Federally Qualified Health Center (FQHC)
  • Carolina, PR
  • NPI 1205200367
  NPD
• Joel C. Ang, MD, PC

  • Family Medicine Physician
  • Washington, DC
  • NPI 1497954069
  NPD

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1205039757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746087",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746087",
            "telephone_number": "833-804-1695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 LIBERTY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112082922",
            "telephone_number": "718-765-6058",
            "fax_number": "347-808-4895"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2020 Ave Borinquen",
            "address_2": "Barrio Obrero",
            "address_purpose": "LOCATION",
            "city": "San Juan",
            "state": "PR",
            "postal_code": "00915",
            "country_code": "US",
            "telephone_number": "787-268-4171 x5012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONILLA-PEREZ",
        "first_name": "JUAN SAMUEL",
        "middle_name": "IGNACIO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-11",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "292251",
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "PR",
            "license": "16664",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "DC",
            "license": "MD048978",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Bongiovanni
• Fanite Bonheur
• Anne Marlene Bonhomme, LPN
• Shelly Boniel, LMSW
• Luisa Bonifacio, PHD
• Aliza Pabua Bonilla, PT
• Anny Madelyn Bonilla, LCSW
• Gaby E Bonilla, MSED
• Lorenzo Rodrigo Bonilla
• Marlin Bonilla

• Family Medicine Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.