Individual provider Active NPI

Bonnie Williams, M.D.

  • Family Medicine Physician
  • Erie, PA
National Provider Identifier
1497754436
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD050886L Issued in PA
Practice address
3413 Cherry St
Erie, PA 16508-2678
Phone
(814) 868-9828
Fax
(814) 868-8561
NPI assigned
Jul 20, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD050886L PA Primary
Family Medicine Physician 207Q00000X 036088153 IL

Addresses

Primary practice location

3413 Cherry St
Erie, PA 16508-2678

Mailing address

3413 Cherry St
Erie, PA 16508-2678
Phone (814) 868-9828

Other practice location 1

834 N Seminary St
201
Galesburg, IL 61401-2852
Phone (309) 343-7139

Other identifiers 1

IdentifierTypeStateIssuer
036088153MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, PA2 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
I20040921000522 IL Practitioner - Family Practice 1153399860
I20230228002734 PA Practitioner - Family Practice 1153399860 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Keystone Rehabilitation Systems IncGroup PAC ID 7012826753, shared by 15 NPIs, 750 clinicians

Practice addresses (Care Compare)

3413 Cherry St
Erie, PA 16508-2678
Phone (814) 868-9828

5930 Old French Rd
Erie, PA 16509-3656
Phone (814) 860-7816

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036088153ILMDFamily Medicine Physician
MD050886LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Medical Education and Research Institute Inc Family Medicine CurrentSince Jan 1, 2023 Accepting new patients

Locations

155 E State St
Albion, PA 16401
Phone (814) 756-4917

3413 Cherry St
Erie, PA 16508
Phone (814) 860-8098

213 E 41st St
Erie, PA 16504
Phone (814) 452-5772

Interoperability endpoints

  • Direct secure messaging: bwilliams571463@direct.ahn.org
  • Direct secure messaging: bmwillia@yourcarecommunity.org

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.

Hospital & facility affiliations 3

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": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1497754436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3413 CHERRY ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165082678",
            "telephone_number": "814-868-9828",
            "fax_number": "814-868-8561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3413 CHERRY ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165082678",
            "telephone_number": "814-868-9828",
            "fax_number": "814-868-8561"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "834 N Seminary St",
            "address_2": "201",
            "address_purpose": "LOCATION",
            "city": "Galesburg",
            "state": "IL",
            "postal_code": "614012852",
            "country_code": "US",
            "telephone_number": "309-343-7139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "BONNIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-20",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD050886L",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036088153",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036088153",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.