Jose Bonnin, M.D.

Primary specialty

Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X

License

01036377A Issued in IN

Practice address

635 Barnhill Dr
A128
Indianapolis, IN 46202-5126

Phone

(317) 274-4806

NPI assigned

Apr 27, 2006

Last updated

Jan 29, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jbonnin@direct.iuhealth.org

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.

• Indiana Pediatric Pathology Institute Inc

  • Pediatric Pathology Physician
  • Indianapolis, IN
  • NPI 1790929669
  NPD (past)

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1366409120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 BARNHILL DR",
            "address_2": "A128",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025126",
            "telephone_number": "317-274-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 BARNHILL DR",
            "address_2": "A128",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025126",
            "telephone_number": "317-274-4806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNIN",
        "first_name": "JOSE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "IN",
            "license": "01036377A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbonnin@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "635 Barnhill Dr",
            "address_2": "A128",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462025126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Erin Danae Bonner
• Latashay Bonner
• Quanah Bonner
• Richard David Bonney Jr., LCAC
• Daniel Alexander Bonnin, MD
• Courtney Sue Bono, NP
• Kiven Bonongwe, FNP
• Carrie F Bonsack, CNM
• Kylie Rochelle Bontrager, D.D.S., M.S.D.
• Thomas Bontrager, MSW

• Clinical Pathology/Laboratory Medicine Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Clinical Pathology/Laboratory Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; 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.