Johnny Bonilla, DPT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

045343-01 Issued in NY

Practice address

191 Patchogue Yaphank Rd
East Patchogue, NY 11772-4899

Phone

(516) 551-4722

Fax

(631) 475-0975

NPI assigned

Jan 23, 2020

Last updated

Jan 24, 2020By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Link Medical Services PLLCGroup PAC ID 7214385111, 13 clinicians

Professional Care Physical Therapy and Rehabilitation P.CGroup PAC ID 7517023351, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Link Medical Services PLLC

  • Specialist
  • Riverhead, NY
  • NPI 1326716887

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Professional Care Physical Therapy and Rehabilitation P.C

  • Physical Therapist
  • East Patchogue, NY
  • NPI 1659518157

  Single Specialty

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1467082958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 PATCHOGUE YAPHANK RD",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724899",
            "telephone_number": "516-551-4722",
            "fax_number": "631-475-0975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 PATCHOGUE YAPHANK RD",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724899",
            "telephone_number": "516-551-4722",
            "fax_number": "631-475-0975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "JOHNNY",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-23",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "045343-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS PT LICENSE",
            "identifier": "045343-01",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Webpt.com",
            "affiliation": "N",
            "address_1": "191 Patchogue Yaphank Rd",
            "city": "East Patchogue",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117724899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nataliya Volodymyrivna Bilokur, M.D.
• Alan Howard Black, D.D.S.
• James J Blair, P.T.
• Caroline Boley, PTA
• Olena Bolotova, M.D.
• Christen Botros, PA-C
• Sandra Boucicaut, NP
• Caroline Catherine Brabazon, MSCCCSLP
• Kathryn Genevieve Bradley, COTA/L
• Suzanne B Brady, MACCC SLP

• Physical Medicine & Rehabilitation Physician in East Patchogue, NY
• Providers in East Patchogue, NY by specialty
• Physical Medicine & Rehabilitation Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; 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.