Active NPI
Enrique Augusto Bonfils-Roberts, M.D.
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Bronx, NY
National Provider Identifier
1437221702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- 111161
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00199202 | Medicaid | NY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 111161 | NY | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Surgical Services of St Vincents PC | Past | Accepting new patients |
Interoperability endpoints
- 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.
-
- Surgery Physician
- New York, NY
- NPI 1851587000
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.