Kevin Bonilla, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

315669-01 Issued in NY

Practice address

3001 Express Dr N
Islandia, NY 11749-5301

Phone

(631) 292-6747

NPI assigned

Apr 10, 2018

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 NY

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

Obstetrics/Gynecology

Education

Howard University College of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Shore Lij OB GYN PCGroup PAC ID 7214172980, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Shore University Hospital Hospital, Manhasset, NY, CCN 330106

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359

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.

• North Shore Lij OB GYN PC

  • Obstetrics Physician
  • Islandia, NY
  • NPI 1033453329
  Medicare reassignment Care Compare group NPD
• Huntington Hospital Dolan Family Health Center

  • Health Service Clinic/Center
  • Greenlawn, NY
  • NPI 1578593588
  Medicare reassignment NPD
• Contemporary OB GYN Physician Specialists PC

  • Specialist
  • Islandia, NY
  • NPI 1184808990
  NPD (past)
• North Shore-Lij Medical PC

  dba NHPP Cardiology at Great Neck

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572

  Obstetrics & Gynecology

  NPD (past)
• South Shore University Hospital

  • General Acute Care Hospital
  • Bay Shore, NY
  • NPI 1457369381
  NPD (past)

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

• North Shore University Hospital

  • General Acute Care Hospital
  • Manhasset, NY
  • NPI 1366459570
  Care Compare affiliation

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

{
    "created_epoch": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1730686403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068408",
            "telephone_number": "631-968-3322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 EXPRESS DR N",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117495301",
            "telephone_number": "631-292-6747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 E Main St",
            "address_purpose": "LOCATION",
            "city": "Bay Shore",
            "state": "NY",
            "postal_code": "117068408",
            "country_code": "US",
            "telephone_number": "631-968-3322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-10",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "315669-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• BJ's Wholesale Club Inc.
• Blue Ridge Care
• Scott Marshall Blyer, MD
• Alyssa Bohonan
• Joseph P Bonafede, M.D.
• Charles Bordes
• Tara Ashling Bovich
• Mary Brady, RN
• Elise Joanne Branca, MD
• Nicole Brander, LMSW

• Obstetrics & Gynecology Physician in Islandia, NY
• Providers in Islandia, NY by specialty
• Obstetrics & Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.