Jorge Bonilla, M.D

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

264692 Issued in NY

Practice address

191 W Hoffman Ave
Lindenhurst, NY 11757-4036

Phone

(631) 608-4741

Fax

(631) 608-4742

NPI assigned

Apr 27, 2011

Last updated

Aug 15, 2023By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Internal Medicine

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HFBHDD/Endpoint/HFBHDD

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.

• Jorge Bonilla MD PC

  • Internal Medicine Physician
  • Lindenhurst, NY
  • NPI 1669038329
  Medicare reassignment NPD Authorized official
• Jorge L Bonilla MD PSC

  dba Jorge L Bonilla Mendez

  • Internal Medicine Physician
  • Mayaguez, PR
  • NPI 1568700664
  NPD (past) Authorized official

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

{
    "created_epoch": "1303862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1376834176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 BROADWAY STE 1",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012797",
            "telephone_number": "631-608-4741",
            "fax_number": "631-608-4742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 W HOFFMAN AVE",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117574036",
            "telephone_number": "631-608-4741",
            "fax_number": "631-608-4742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "JORGE",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-27",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "264692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04343519",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blessed Healthcare and Staffing Agency
• Dominique Dorothy Block, NP
• Blossoming Lotus Therapy LCSW PLLC
• Blue PT Physical Therapy PLLC
• Caroline A. Boettcher, PSY.D.
• Lindsey Garcia Borges, MA, BCBA, LBA
• Nicole M Borgesano, LMT
• Gabriela Botero
• Rachel Leah Boyd, PSY.D.
• Melissa Brancale, MSW

• Internal Medicine Physician in Lindenhurst, NY
• Providers in Lindenhurst, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.