Individual provider Active NPI

Jonh James Pineda-Bonilla, MD

  • Gastroenterology Physician
  • Salem, VA
National Provider Identifier
1760640429
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
0101256322 Issued in VA
Practice address
1802 Braeburn Dr
Salem, VA 24153-7357
Phone
(540) 772-5970
Fax
(540) 725-5006
NPI assigned
May 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT188722 PA
Gastroenterology Physician 207RG0100X 0101256322 VA Primary

Addresses

Primary practice location

1802 Braeburn Dr
Salem, VA 24153-7357

Mailing address

1802 Braeburn Dr
Salem, VA 24153-7357
Phone (540) 772-5970

Other identifiers 1

IdentifierTypeStateIssuer
1760640429MedicaidVA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jonh.pinedabonilla@hca6.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20140813001008 VA Practitioner - GastroenterologyPractitioner - Internal Medicine 5698829240 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lewis Gale Physicians LLCGroup PAC ID 6507886231, 191 clinicians

Practice addresses (Care Compare)

1802 Braeburn Dr
Salem, VA 24153-7357

1900 Electric Rd
Salem, VA 24153-7474

Hospital & facility affiliations

  • Lewisgale Medical Center Hospital, Salem, VA, CCN 490048
  • Lewisgale Hospital Montgomery Hospital, Blacksburg, VA, CCN 490110

Merit-based Incentive Payment System (MIPS)

Final score
82.67 of 100Reported as group
Quality
66.8
Promoting interoperability
100
Improvement activities
40
Cost
75.45

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy193
Upper gastrointestinal (GI) endoscopy for acid reflux979

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT188722PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lewis Gale Physicians LLC Internal Medicine CurrentSince Aug 1, 2014 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

1802 Braeburn Dr
Salem, VA 24153
Phone (540) 772-3400

Interoperability endpoints

  • Direct secure messaging: jonh.pinedabonilla@hca6.eclinicaldirectplus.com

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1760640429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 BRAEBURN DR",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537357",
            "telephone_number": "540-772-5970",
            "fax_number": "540-725-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 BRAEBURN DR",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537357",
            "telephone_number": "540-772-5970",
            "fax_number": "540-725-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINEDA-BONILLA",
        "first_name": "JONH",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-29",
        "last_updated": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT188722",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VA",
            "license": "0101256322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760640429",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jonh.pinedabonilla@hca6.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "1802 Braeburn Dr",
            "city": "Salem",
            "state": "VA",
            "country_code": "US",
            "postal_code": "241537357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salem, VA

Sources for this page

Verify at the official NPI Registry.