Individual provider Active NPI

Dennis M Orellana Bonilla, NP

  • Nurse Practitioner
  • Pleasant Prairie, WI
National Provider Identifier
1992177976
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
10203 Issued in WI
Practice address
12500 Aurora Dr
Pleasant Prairie, WI 53158-1227
Phone
(262) 857-5000
NPI assigned
Oct 29, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 10203 WI Primary

Addresses

Primary practice location

12500 Aurora Dr
Pleasant Prairie, WI 53158-1227

Mailing address

PO Box 735044
Chicago, IL 60673-6223
Phone (262) 857-5000

Other practice location 1

8215 25th Ave
Kenosha, WI 53143-6223
Phone (262) 365-1319

Other practice location 2

10400 75th St
Kenosha, WI 53142-7884
Phone (262) 948-5600

Other identifiers 1

IdentifierTypeStateIssuer
100104753MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address dorellanabonilla171303@direct.myadvocateaurora.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20201002000231 WI Practitioner - Nurse Practitioner 0749609238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

10400 75TH St
Kenosha, WI 53142-7884
Phone (262) 948-7000

Hospital & facility affiliations

  • Aurora Medical Center Kenosha Hospital, Kenosha, WI, CCN 520189

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Oct 26, 2020 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Oct 26, 2020 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

10400 75th St
Kenosha, WI 53142
Phone (262) 697-7000

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

13250 Washington Ave
Mount Pleasant, WI 53177
Phone (262) 799-8330

12500 Aurora Dr
Pleasant Prairie, WI 53158
Phone (262) 857-5000

Interoperability endpoints

  • Direct secure messaging: dorellanabonilla171303@direct.myadvocateaurora.org

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1446076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1992177976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606736223",
            "telephone_number": "262-857-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12500 AURORA DR",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531581227",
            "telephone_number": "262-857-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8215 25th Ave",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "531436223",
            "country_code": "US",
            "telephone_number": "262-365-1319",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10400 75th St",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "531427884",
            "country_code": "US",
            "telephone_number": "262-948-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ORELLANA BONILLA",
        "first_name": "DENNIS",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-29",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "10203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100104753",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "12500 Aurora Dr",
            "city": "Pleasant Prairie",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531581227",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dorellanabonilla171303@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "12500 Aurora Dr",
            "city": "Pleasant Prairie",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531581227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pleasant Prairie, WI

Sources for this page

Verify at the official NPI Registry.