Individual provider Active NPI

Yusimi Sobrino-Bonilla, APN

  • Adult Health Nurse Practitioner
  • Hackensack, NJ
National Provider Identifier
1275938250
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ00528200 Issued in NJ
Practice address
30 Prospect Ave
Hackensack, NJ 07601-1915
Phone
(551) 996-2442
Fax
(201) 343-1045
NPI assigned
Nov 3, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 26NJ00528200 NJ Primary

Addresses

Primary practice location

30 Prospect Ave
Hackensack, NJ 07601-1915

Mailing address

331 Newman Springs Rd Ste 220
Red Bank, NJ 07701-5792
Phone (732) 807-0877

Other practice location 1

223 N Van Dien Ave
Ridgewood, NJ 07450-2726
Phone (201) 447-8413

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150205001817 NJ Practitioner - Nurse Practitioner 4082939483 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Physician Services PCGroup PAC ID 3577857333, 593 clinicians
Hackensack Meridian Health Medical Group - Specialty Care PCGroup PAC ID 9133032519, 1,901 clinicians

Practice addresses (Care Compare)

108 Jackson St
Apt 6B
Hoboken, NJ 07030-6101
Phone (800) 825-5391

30 Prospect Ave
Hackensack, NJ 07601-1915
Phone (551) 996-1288

Hospital & facility affiliations

  • Hackensack University Medical Center Hospital, Hackensack, NJ, CCN 310001
  • Valley Hospital Hospital, Paramus, NJ, CCN 310012

Merit-based Incentive Payment System (MIPS)

Final score
95.05 of 100Reported as apm
Quality
85.71
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
81.33 of 100Reported as group
Quality
66.38
Promoting interoperability
100
Improvement activities
40
Cost
71.39

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Oct 14, 2024 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Oct 14, 2024 Accepting new patients
Valley Physician Services PC CurrentSince Jul 1, 2016 Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

1 Valley Health Plz
Paramus, NJ 07652
Phone (201) 634-5353

331 Newman Springs Rd
Ste 220
Red Bank, NJ 07701
Phone (732) 807-0514

223 N Van Dien Ave
Ridgewood, NJ 07450
Phone (201) 447-8417

Interoperability endpoints

  • Direct secure messaging: yusimi.sobrino-bonilla.1@5622.direct.athenahealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 3

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 3

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": "1414972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1275938250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 NEWMAN SPRINGS RD STE 220",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015792",
            "telephone_number": "732-807-0877",
            "fax_number": "201-751-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011915",
            "telephone_number": "551-996-2442",
            "fax_number": "201-343-1045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "223 N Van Dien Ave",
            "address_purpose": "LOCATION",
            "city": "Ridgewood",
            "state": "NJ",
            "postal_code": "074502726",
            "country_code": "US",
            "telephone_number": "201-447-8413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOBRINO-BONILLA",
        "first_name": "YUSIMI",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-03",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00528200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.