Individual provider Active NPI

Carlos Antonio Bonilla-Ruiz

  • Medical Physician Assistant
  • Ponce, PR
National Provider Identifier
1871463737
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA-1072 Issued in PR
Practice address
Estancias del Oriol
209
Ponce, PR 00730
Phone
(787) 396-1860
NPI assigned
Nov 6, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA-1072 PR Primary

Addresses

Primary practice location

Estancias del Oriol
209
Ponce, PR 00730

Mailing address

Estancias del Oriol
209
Ponce, PR 00730
Phone (787) 396-1860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PA-1072PRMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1762387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1871463737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ESTANCIAS DEL ORIOL",
            "address_2": "209",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00730",
            "telephone_number": "787-396-1860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ESTANCIAS DEL ORIOL",
            "address_2": "209",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00730",
            "telephone_number": "787-396-1860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA-RUIZ",
        "first_name": "CARLOS",
        "middle_name": "ANTONIO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-11-06",
        "last_updated": "2025-11-06",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PR",
            "license": "PA-1072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; 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.