Javier Bonilla

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

S1986 Issued in TX

Practice address

4502 Medical Dr
San Antonio, TX 78229-4402

Phone

(210) 358-2015

NPI assigned

Apr 7, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Pediatric Medicine

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Texas Health Science Center at San AntonioGroup PAC ID 0042128548, 1,290 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University Health System Hospital, San Antonio, TX, CCN 450213

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• University of Texas Health Science Center at San Antonio

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1720051717

  Pediatrics

  Medicare reassignment Care Compare group NPD
• Texas Inpatient Pediatrics, PA

  • Pediatrics Physician
  • San Antonio, TX
  • NPI 1760632970
  NPD
• The University of Texas Health Science Center at San Antonio

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1326829904
  NPD
• Bexar County Hospital District

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1821011248

  Pediatrics

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bexar County Hospital District

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1821011248
  Care Compare affiliation

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

{
    "created_epoch": "1428364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1689060642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-358-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-358-2015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13022 Jones Maltsberger Rd",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782474219",
            "country_code": "US",
            "telephone_number": "210-491-0772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "JAVIER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-07",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "S1986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jorge Luis Bonilla Velez, DC
• Glenda Lee Bonilla-Santos
• Corina Alyssa Bonilla, OD
• Diego Bonilla, DDS
• Esther Laura Bonilla, D.D.S
• Jorge Alberto Bonilla, M.D.
• Jose Arturo Bonilla, M.D.
• Joseph Bonilla, PHD, RD
• Juan Alfredo Bonilla, M.D.
• Raul Jose Bonilla

• Pediatrics Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; 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.

Verify at the official NPI Registry.