Individual provider Active NPI

William James Bonner, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Miami, FL
National Provider Identifier
1487919759
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
ME129977 Issued in FL
Practice address
4960 SW 72ND Ave Ste 408
Miami, FL 33155-5506
Phone
(786) 522-4959
Fax
(786) 522-4959
NPI assigned
Jul 11, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X ME129977 FL
Physical Medicine & Rehabilitation Physician 208100000X MD450453 PA
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X ME129977 FL Primary

Addresses

Primary practice location

4960 SW 72ND Ave Ste 408
Miami, FL 33155-5506

Mailing address

4960 SW 72ND Ave Ste 408
Miami, FL 33155-5506
Phone (786) 517-4577

Other identifiers 1

IdentifierTypeStateIssuer
019186500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140807000232 PA Practitioner - Physical Medicine and Rehabilitation 3779700208 Reassigns benefits to 2 organizations
Practice locations: Chester, PA
I20161228001289 FL Practitioner - Physical Medicine and Rehabilitation 3779700208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Temple University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ortho Florida LLCGroup PAC ID 3274616453, 121 clinicians

Practice addresses (Care Compare)

4960 SW 72ND Ave
Suite 408
Miami, FL 33155-5506
Phone (786) 517-4577

6125 SW 31St St
Miami, FL 33155-3003
Phone (305) 666-6511

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME129977FLMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ortho Florida, LLC Multi-Specialty CurrentSince Jun 1, 2023 Accepting new patients
University of Penn-Medical Group Multi-Specialty CurrentSince Sep 1, 2015 Accepting new patients
University of Penn-Medical Group Multi-Specialty CurrentSince Sep 1, 2015 Accepting new patients
University of Penn-Medical Group Multi-Specialty Current Accepting new patients
Ortho Florida, LLC Multi-Specialty CurrentSince Jun 1, 2023 Accepting new patients
Physical Therapy Physicians PC Multi-Specialty Past Accepting new patients
Matmed LLC PastSince Apr 15, 2022 Accepting new patients

Locations

660 Glades Rd
Ste 460
Boca Raton, FL 33431
Phone (561) 300-1792

433 Plaza Real
Ste 275
Boca Raton, FL 33432
Phone (561) 262-0084

9195 Sunset Dr
Ste 100
Miami, FL 33173
Phone (305) 598-3223

4960 SW 72nd Ave
Ste 408
Miami, FL 33155
Phone (786) 517-4577

6125 SW 31st St
Miami, FL 33155
Phone (305) 662-5056

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

1800 Lombard St
Philadelphia, PA 19146
Phone (215) 545-4173

3400 Spruce St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-2428

Interoperability endpoints

  • Direct secure messaging: william.bonner@direct.einstein.edu

Organizations & group practices 27

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.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1487919759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4960 SW 72ND AVE STE 408",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331555506",
            "telephone_number": "786-517-4577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4960 SW 72ND AVE STE 408",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331555506",
            "telephone_number": "786-522-4959",
            "fax_number": "786-522-4959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNER",
        "first_name": "WILLIAM",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-11",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME129977",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MD450453",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "FL",
            "license": "ME129977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019186500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.