Marisol Irizarry-Bonilla, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

15521 Issued in PR

Practice address

Carr#181 KM.9.1 Bo Dos Bocas
Trujillo Alto, PR 00976
UM

Phone

(787) 760-5545

Fax

(787) 760-5545

NPI assigned

Jun 12, 2006

Last updated

Aug 13, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

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.

• Myt Clinical Services, P.S.C.

  • Primary Care Clinic/Center
  • Trujillo Alto, PR
  • NPI 1295144806
  NPD (past)

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1922040187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PLAZA DEL PARQUE",
            "address_2": "APT 346",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "009763010",
            "telephone_number": "787-760-5545",
            "fax_number": "787-760-5545"
        },
        {
            "country_code": "UM",
            "country_name": "United States Minor Outlying Islands",
            "address_purpose": "LOCATION",
            "address_type": "FGN",
            "address_1": "CARR#181 KM.9.1 BO DOS BOCAS",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "00976",
            "telephone_number": "787-760-5545",
            "fax_number": "787-760-5545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRIZARRY-BONILLA",
        "first_name": "MARISOL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "15521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "luy-2@hotmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "Carr#181 KM.9.1 Bo Dos Bocas",
            "city": "Trujillo Alto",
            "state": "PR",
            "country_code": "UM",
            "postal_code": "00976",
            "country_name": "United States Minor Outlying Islands",
            "address_type": "FGN"
        }
    ],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.