Active NPI
Manuel Eduardo Perez-Bonnelly, M.D.
- Internal Medicine Physician
- Baltimore, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- D0067680
- Practice address
- 1777 Reisterstown Rd
Suite 222
Baltimore, MD 21208-1306 - Phone
- (410) 415-0933
- Fax
- (410) 415-0935
- NPI assigned
- May 9, 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | D0067680 | MD | Primary |
Addresses
Primary practice location
1777 Reisterstown Rd
Suite 222
Baltimore, MD 21208-1306
Mailing address
1777 Reisterstown Rd
Suite 222
Baltimore, MD 21208-1306
Phone (410) 415-0933
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
12 Irondale St
Suite 120
Middle River, MD 21220-2172
Phone (410) 687-3924
12 Newport Dr
Forest Hill, MD 21050-1758
Hospital & facility affiliations
- Medstar Health Home Care
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0067680 | MD | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health MD LLC | Internal Medicine | Current | Accepting new patients |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations
12 Irondale St
Ste 120
Middle River, MD 21220
Phone (410) 687-3924
11560 Crossroads Cir
Ste 106
Middle River, MD 21220
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- Middle River, MD
- NPI 1568823854
-
- Physical Therapist
- Forest Hill, MD
- NPI 1578900668
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Baltimore, MD
- NPI 1790899524
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320019200000",
"number": "1508815283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1777 REISTERSTOWN RD",
"address_2": "SUITE 222",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212081306",
"telephone_number": "410-415-0933",
"fax_number": "410-415-0935"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1777 REISTERSTOWN RD",
"address_2": "SUITE 222",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212081306",
"telephone_number": "410-415-0933",
"fax_number": "410-415-0935"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ-BONNELLY",
"first_name": "MANUEL",
"middle_name": "EDUARDO",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-09",
"last_updated": "2011-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MD",
"license": "D0067680",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.