Alex Bonilla, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

328642 Issued in NY

Practice address

300 Community Dr
Manhasset, NY 11030-3816

Phone

(516) 562-2925

NPI assigned

Mar 26, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Emergency Medicine

Education

Harvard Medical School, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Icahn School of Medicine at Mount SinaiGroup PAC ID 1850514258, 29 clinicians

Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mount Sinai West Hospital, New York, NY, CCN 330046
• Mount Sinai Beth Israel Hospital, New York, NY, CCN 330169
• Ny Eye and Ear Infirmary of Mount Sinai Hospital, New York, NY, CCN 330100

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles (7 of 10)

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359

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.

• Icahn School of Medicine at Mount Sinai

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1124392238

  Emergency Medicine, NY

  Medicare reassignment Care Compare group NPD
• Icahn School of Medicine at Mount Sinai

  • Rehabilitation Practitioner
  • New York, NY
  • NPI 1477899078

  NY

  Medicare reassignment NPD
• Icahn School of Medicine at Mount Sinai

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1679083984

  Emergency Medicine, NY

  Medicare reassignment NPD
• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572

  Emergency Medicine, NY

  Medicare reassignment NPD
• Icahn School of Medicine at Mount Sinai

  • Eyewear Supplier
  • New York, NY
  • NPI 1760227466
  NPD
• North Shore - Lij Medical PC

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1790043479
  NPD
• Icahn School of Medicine at Mount Sinai

  • Infectious Disease Physician
  • New York, NY
  • NPI 1659639524
  NPD (past)

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

• Beth Israel Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1174689665

  Hospital

  Care Compare affiliation
• Beth Israel Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1174768071

  Hospital

  Care Compare affiliation
• Beth Israel Medical Center

  • Substance Use Disorder Rehabilitation Hospital Unit
  • New York, NY
  • NPI 1770951204

  Hospital

  Care Compare affiliation
• New York Eye & Ear Infirmary

  • Special Hospital
  • New York City, NY
  • NPI 1245251222

  Hospital

  Care Compare affiliation
• St Lukes Roosevelt Hospital Center

  • General Acute Care Hospital
  • New York, NY
  • NPI 1104982917

  Hospital

  Care Compare affiliation
• St. Lukes Roosevelt Hospital Center

  • Methadone Clinic
  • New York, NY
  • NPI 1609476357

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1992332159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 COMMUNITY DR",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303816",
            "telephone_number": "516-562-2925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 COMMUNITY DR",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303816",
            "telephone_number": "516-562-2925"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Gustave L. Place",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10029",
            "country_code": "US",
            "telephone_number": "212-824-8069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "ALEX",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-26",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "328642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yevgen Bogatyryov, DPT
• Christina Marie Bognacki, NP
• Kristen Bohan, PT,DPT
• Kimberly Bohnak, M.A. CFY-SLP
• Tsivia Boim, NP
• Adira Boniuk, MD
• Julia Bonvino
• Keenan Alvarez Borde, MD
• Zachary Allen Bordeaux
• David Borukhov, MD

• All providers in Manhasset, NY
• Emergency Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.