Nicholas D Bonfilio, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

7695 Issued in MT

Practice address

3000 15TH Ave S
Great Falls Clinic
Great Falls, MT 59405

Phone

(406) 454-2171

Fax

(406) 771-3021

NPI assigned

Aug 12, 2005

Last updated

Aug 5, 2011By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312502400000",
    "number": "1790787372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 29TH ST S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594055353",
            "telephone_number": "406-454-2171",
            "fax_number": "406-771-3021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 15TH AVE S",
            "address_2": "GREAT FALLS CLINIC",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "59405",
            "telephone_number": "406-454-2171",
            "fax_number": "406-771-3021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONFILIO",
        "first_name": "NICHOLAS",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2011-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MT",
            "license": "7695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0106379",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robin L. Boland, FNP
• Eugene Bollwitt
• Jill Denise Bolstad, MD
• Kayla J Boltz, FNP
• Lauren Bomgardner
• Nikki Sue Bonilla King, FNP
• Erica M Bonilla, DPT
• Victor Bonilla, SA-C
• Cassidy Marie Booms
• David Borg

• Orthopaedic Surgery Physician in Great Falls, MT
• Providers in Great Falls, MT by specialty
• Orthopaedic Surgery Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.