NPIMap

Individual provider Active NPI

Daniel Bonilla, CRNA

  • Certified Registered Nurse Anesthetist
  • Caldwell, ID
National Provider Identifier
1386408730
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
78711 Issued in ID
Practice address
1717 Arlington Ave
Caldwell, ID 83605-4802
Phone
(208) 459-4641
NPI assigned
Feb 7, 2024
Last updated
Feb 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 78711 ID Primary

Addresses

Primary practice location

1717 Arlington Ave
Caldwell, ID 83605-4802

Mailing address

1717 Arlington Ave
Caldwell, ID 83605-4802

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240507004523 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 4183065246 Reassigns benefits to 1 organization
I20251210000963 CO Practitioner - Certified Registered Nurse Anesthetist (Crna) 4183065246 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Consulting Partners Idaho PCGroup PAC ID 5092164806, 8 clinicians
Animas Surgical Hospital LLCGroup PAC ID 0143295428, 61 clinicians

Practice addresses (Care Compare)

1717 Arlington Ave
Caldwell, ID 83605-4802
Phone (208) 459-4641

575 Rivergate LN
Durango, CO 81301-7487
Phone (970) 247-3537

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Durango Surgery Center LLC Single Specialty CurrentSince Dec 1, 2025 Accepting new patients
Anesthesia Consulting Partners Idaho, PC Single Specialty CurrentSince Feb 7, 2024 Accepting new patients
Animas Surgical Hospital, LLC Single Specialty CurrentSince Dec 1, 2025 Accepting new patients

Locations

575 Rivergate Ln
Durango, CO 81301
Phone (719) 648-5678

1717 Arlington Ave
Caldwell, ID 83605
Phone (208) 455-3719

6128 S Lyncrest Ave
Sioux Falls, SD 57108
Phone (605) 334-1363

6330 S Western Ave
Ste 150
Sioux Falls, SD 57108

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1707264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1386408730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 ARLINGTON AVE",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 ARLINGTON AVE",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054802",
            "telephone_number": "208-459-4641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "DANIEL",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-07",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "78711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.