Active NPI
Luis Angel Bonilla Gonzalez, M.D.
- Infectious Disease Physician
- San Juan, PR
National Provider Identifier
1750588802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- 16705
- Practice address
- Urb. Crown Hills Calle Carite #143
San Juan, PR 00926 - Phone
- (787) 754-2719
- NPI assigned
- Jul 2, 2007
- Last updated
- Dec 2, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 16705 | PR | |
| Infectious Disease Physician | 207RI0200X | 16705 | PR | Primary |
Addresses
Primary practice location
Urb. Crown Hills Calle Carite #143
San Juan, PR 00926
Mailing address
138 W. Churchill Ave. Suite 533
San Juan, PR 00926
Phone (787) 309-7344
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091211000065 | PR | Practitioner - Infectious Disease | 3779623442 | Practice locations: San Juan, PR |
Care Compare profile
Medicare Care Compare- Specialty
- Infectious Disease
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1451 Ave Ashford
San Juan, PR 00907-1511
Phone (787) 309-7344
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Ashford Presbyterian Community Hospital
- General Acute Care Hospital
- San Juan, PR
- NPI 1770580813
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259712000000",
"number": "1750588802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "138 W. CHURCHILL AVE. SUITE 533",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00926",
"telephone_number": "787-309-7344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "URB. CROWN HILLS CALLE CARITE #143",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00926",
"telephone_number": "787-754-2719"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONILLA GONZALEZ",
"first_name": "LUIS",
"middle_name": "ANGEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-02",
"last_updated": "2009-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PR",
"license": "16705",
"primary": false
},
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "PR",
"license": "16705",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Juan, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2009; 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.