Individual provider Active NPI

Enrique Augusto Bonfils-Roberts, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Bronx, NY
National Provider Identifier
1437221702
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
111161 Issued in NY
Practice address
234 E 149TH St
620
Bronx, NY 10451-5504
Phone
(718) 579-5900
Fax
(718) 579-4620
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 111161 NY Primary

Addresses

Primary practice location

234 E 149TH St
620
Bronx, NY 10451-5504

Mailing address

15 Charles St
18-B
New York, NY 10014-3011
Phone (212) 675-8422

Other identifiers 1

IdentifierTypeStateIssuer
00199202MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
111161NYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Surgical Services of St Vincents PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ebonfilsroberts839178@nychhc.direct-ci.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437221702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 CHARLES ST",
            "address_2": "18-B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100143011",
            "telephone_number": "212-675-8422",
            "fax_number": "718-579-4620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 E 149TH ST",
            "address_2": "620",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515504",
            "telephone_number": "718-579-5900",
            "fax_number": "718-579-4620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONFILS-ROBERTS",
        "first_name": "ENRIQUE",
        "middle_name": "AUGUSTO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NY",
            "license": "111161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00199202",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.