Individual provider Active NPI

Yadaris Rachelle Bonilla

  • Physician Assistant
  • Grapevine, TX
National Provider Identifier
1780462838
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA17543 Issued in TX
Practice address
1600 W Northwest Hwy Ste 100
Grapevine, TX 76051-8131
Phone
(817) 912-0442
NPI assigned
Sep 19, 2023
Last updated
May 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA17543 TX Primary

Addresses

Primary practice location

1600 W Northwest Hwy Ste 100
Grapevine, TX 76051-8131

Mailing address

6011 Harry Hines Blvd
Dallas, TX 75235-5386
Phone (214) 648-1500

Other practice location 1

6011 Harry Hines Blvd
Dallas, TX 75235-5386
Phone (214) 648-1500

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240429000191 TX Practitioner - Physician Assistant 4688014343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

1600 Hospital Pkwy
Bedford, TX 76022-6913
Phone (817) 684-2708

1600 W Northwest Hwy
Suite 100
Grapevine, TX 76051-8131
Phone (817) 912-0442

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group CurrentSince Jun 1, 2025 Accepting new patients
Texas Health Physicians Group CurrentSince Jun 1, 2025 Accepting new patients

Locations

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

3427 Trinity Mills Rd
Ste 800
Dallas, TX 75287
Phone (214) 566-9616

1600 W Northwest Hwy
Ste 100
Grapevine, TX 76051
Phone (817) 424-4091

Interoperability endpoints

  • Direct secure messaging: ybonilla2068898@direct.texashealth.org

Organizations & group practices 2

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": "1695081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1780462838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6011 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752355386",
            "telephone_number": "214-648-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W NORTHWEST HWY STE 100",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760518131",
            "telephone_number": "817-912-0442"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6011 Harry Hines Blvd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752355386",
            "country_code": "US",
            "telephone_number": "214-648-1500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "YADARIS",
        "middle_name": "RACHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-19",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA17543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grapevine, TX

Sources for this page

Verify at the official NPI Registry.