Individual provider Active NPI

Hemmily Bonilla-Prescott, MD

  • Pediatrics Physician
  • Minneapolis, MN
National Provider Identifier
1942406871
Registry record updated Aug 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
18545 Issued in MN
Practice address
420 Delaware St SE
MMC 293
Minneapolis, MN 55455-0341
Phone
(612) 625-7634
NPI assigned
Jun 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 18545 MN Primary

Addresses

Primary practice location

420 Delaware St SE
MMC 293
Minneapolis, MN 55455-0341

Mailing address

631 Fillmore St NE
Minneapolis, MN 55413-2523

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20171221000860 WA Practitioner - Pediatric Medicine 3072871086 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18545MNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Apr 1, 2019 Accepting new patients
Multicare Health System CurrentSince Apr 1, 2019 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

200 Lilly Rd NE
Ste C
Olympia, WA 98506
Phone (360) 918-8336

317 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 403-1400

Interoperability endpoints

  • Direct secure messaging: hbonilla419678@direct.multicare.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186704000000",
    "number": "1942406871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 FILLMORE ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554132523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 DELAWARE ST SE",
            "address_2": "MMC 293",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550341",
            "telephone_number": "612-625-7634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA-PRESCOTT",
        "first_name": "HEMMILY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-26",
        "last_updated": "2007-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "18545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.