John Michael Bonilla Hernandez, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

004614 Issued in PR

Practice address

Ed Centerplex Carretera #2 KM 133.5
Suite 103
Aguada, PR 00602

Phone

(787) 891-4833

Fax

(787) 882-5405

NPI assigned

Aug 5, 2019

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 PR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clinica de Medicina Fisica Y Electrodiagnostico IncGroup PAC ID 8123115532, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles (2 of 4)

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Clinica de Medicina Fisica Y Electrodiagnostico Inc.

  • Physical Therapy Clinic/Center
  • Aguadilla, PR
  • NPI 1558411884

  PR

  Medicare reassignment Care Compare group NPD
• Mayaguez Medical Center Dr Ramon Emeterio Betances Inc

  • General Acute Care Hospital
  • Mayaguez, PR
  • NPI 1013140383
  NPD

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

{
    "created_epoch": "1564963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654905600000",
    "number": "1811542012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 CALLE CENTRAL",
            "city": "AGUADA",
            "state": "PR",
            "postal_code": "006028697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ED CENTERPLEX CARRETERA #2 KM 133.5",
            "address_2": "SUITE 103",
            "city": "AGUADA",
            "state": "PR",
            "postal_code": "00602",
            "telephone_number": "787-891-4833",
            "fax_number": "787-882-5405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA HERNANDEZ",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-05",
        "last_updated": "2022-06-11",
        "certification_date": "2022-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PR",
            "license": "004614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teyshka Margarita Bassatt-Cabrera, MD
• Elisnel Bermudez Valentin
• Carmen Lizzette Betancourt Muniz, P.T.
• Bethzaida Matias Laboratorio Clinico Tu Salud
• Wilmarys Bonilla Benique
• Pablo Carlos Bonilla Soto, (MD)
• Bonilla Transport Services Inc.
• Mabel M. Bonilla, M.D.
• Eduardo Bosques Soto, M.D.
• Mayra Lynette Butter-Rodriguez

• All providers in Aguada, PR
• Physical Therapist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.