Individual provider Active NPI

Liliana Elizabeth Bonilla Hernandez, FNP-BC

  • Family Nurse Practitioner
  • Reston, VA
National Provider Identifier
1912857947
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024196102 Issued in VA
Practice address
1939 Roland Clarke PL Ste 200
Reston, VA 20191-1445
Phone
(703) 435-3366
Fax
(703) 782-8833
NPI assigned
Jan 29, 2026
Last updated
Jan 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024196102 VA Primary

Addresses

Primary practice location

1939 Roland Clarke PL Ste 200
Reston, VA 20191-1445

Mailing address

1939 Roland Clarke PL Ste 200
Reston, VA 20191-1445
Phone (703) 435-3366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20260220003581 DC Practitioner - Nurse Practitioner 9032690797 Reassigns benefits to 1 organization
I20260221001055 VA Practitioner - Nurse Practitioner 9032690797 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastroenterology Associates of Northern Virginia, LLCGroup PAC ID 1759371008, 98 clinicians

Practice addresses (Care Compare)

1939 Roland Clarke PL
Suite 200
Reston, VA 20191-1445
Phone (703) 766-2650

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024196102VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Associates of Northern Virginia, LLC CurrentSince Feb 26, 2026 Accepting new patients
Old Dominion Anesthesia LLC Past Accepting new patients

Locations

3022 Williams Dr
Ste 301
Fairfax, VA 22031
Phone (703) 698-1775

1939 Roland Clarke Pl
Ste 200
Reston, VA 20191
Phone (703) 435-3366

24570 Medical Dr
Sterling, VA 20166
Phone (571) 367-4400

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": "1769644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1912857947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1939 ROLAND CLARKE PL STE 200",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201911445",
            "telephone_number": "703-435-3366",
            "fax_number": "703-782-8833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1939 ROLAND CLARKE PL STE 200",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201911445",
            "telephone_number": "703-435-3366",
            "fax_number": "703-782-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA HERNANDEZ",
        "first_name": "LILIANA",
        "middle_name": "ELIZABETH",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-29",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024196102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

Verify at the official NPI Registry.