NPIMap

Individual provider Active NPI

Gabriel Bonilla, M. D.

  • Psychiatry Physician
  • Ponce, PR
National Provider Identifier
1245680479
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
21386 Issued in PR
Practice address
1542 Calle Santiago Oppenheimer
Ponce, PR 00728-3900
Phone
(787) 204-8378
NPI assigned
Jun 19, 2016
Last updated
Aug 21, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 21386 PR Primary

Addresses

Primary practice location

1542 Calle Santiago Oppenheimer
Ponce, PR 00728-3900

Mailing address

1542 Calle Santiago Oppenheimer
Ponce, PR 00728-3900
Phone (787) 204-8378

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201014002275 PR Practitioner - Psychiatry 5294153151 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inspira Behavioral Care CorpGroup PAC ID 5294863262, 20 clinicians

Practice addresses (Care Compare)

202 Calle Gautier Benitez
Caguas, PR 00725-5512
Phone (787) 704-0705

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Salud Integral En la Montana, Inc CurrentSince Jan 29, 2026 Accepting new patients
Inspira Behavioral Care Corp. Current Accepting new patients
Inspira Behavioral Care Corp. CurrentSince Jul 9, 2020 Accepting new patients
Salud Integral En la Montana, Inc. CurrentSince Jan 29, 2026 Accepting new patients
Inspira Behavioral Care Corp CurrentSince Jul 9, 2020 Accepting new patients
Cambios En Vida Health Management LLC Current Accepting new patients
Salud Integral En la Montana, Inc. CurrentSince Jan 29, 2026 Accepting new patients
Inspira Psychiatric Services PSC Past Accepting new patients
Instituto Psicoterapeutico de PR PastSince Jul 9, 2020 Accepting new patients
San Juan Capestrano Hospital, Inc. Past Accepting new patients

Organizations & group practices 12

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": "1466294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1245680479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1542 CALLE SANTIAGO OPPENHEIMER",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007283900",
            "telephone_number": "787-204-8378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1542 CALLE SANTIAGO OPPENHEIMER",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007283900",
            "telephone_number": "787-204-8378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "GABRIEL",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-19",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PR",
            "license": "21386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.