Individual provider Active NPI

Maggie M. Bonilla, DO

  • Family Medicine Physician
  • Ontario, OR
National Provider Identifier
1649705492
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO219284 Issued in OR
Practice address
840 SW 4TH Ave Ste 105
Ontario, OR 97914-2638
Phone
(541) 881-2800
Fax
(541) 881-2825
NPI assigned
Apr 28, 2017
Last updated
Jun 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 14735A WY
Pediatrics Physician 208000000X DR.0077607 CO
Family Medicine Physician 207Q00000X DO219284 OR Primary

Addresses

Primary practice location

840 SW 4TH Ave Ste 105
Ontario, OR 97914-2638

Mailing address

1441 NE 10TH Ave
Payette, ID 83661-5420
Phone (208) 642-9376

Other practice location 1

1311 N Mildred Rd
Cortez, CO 81321-2231
Phone (970) 565-6666

Other identifiers 1

IdentifierTypeStateIssuer
500840592MedicaidOR

Other names 1

  • Maggie Gerk Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240617004081 OR Practitioner - Family PracticePractitioner - Pediatric Medicine 3577981141 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO219284ORMDFamily Medicine Physician
14735AWYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Family Health Care, Inc Current Accepting new patients
Valley Family Health Care Inc Family Medicine CurrentSince Jul 29, 2024 Accepting new patients
Valley Family Health Care, Inc Family Medicine CurrentSince Jul 29, 2024 Accepting new patients
Valley Family Health Care, Inc Family Medicine Past Accepting new patients
Valley Family Health Care, Inc Family Medicine Past Accepting new patients

Locations

1441 NE 10th Ave
Payette, ID 83661
Phone (208) 642-9376

17 S 3rd St
Nyssa, OR 97913
Phone (541) 372-5738

840 SW 4th Ave
Ste 105
Ontario, OR 97914
Phone (541) 881-2500

896 Fortner St
Ontario, OR 97914
Phone (541) 709-2038

789 Washington St W
Vale, OR 97918
Phone (503) 473-2101

Interoperability endpoints

  • Direct secure messaging: mbonilla719711@direct.ochin.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1493337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1649705492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 NE 10TH AVE",
            "city": "PAYETTE",
            "state": "ID",
            "postal_code": "836615420",
            "telephone_number": "208-642-9376",
            "fax_number": "208-642-9598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 SW 4TH AVE STE 105",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979142638",
            "telephone_number": "541-881-2800",
            "fax_number": "541-881-2825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1311 N Mildred Rd",
            "address_purpose": "LOCATION",
            "city": "Cortez",
            "state": "CO",
            "postal_code": "813212231",
            "country_code": "US",
            "telephone_number": "970-565-6666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "MAGGIE",
        "middle_name": "M.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-28",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WY",
            "license": "14735A",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "DR.0077607",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO219284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500840592",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAGGIE",
            "last_name": "GERK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ontario, OR

Sources for this page

Verify at the official NPI Registry.