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BRENDA BONILLA
NPI 1003342155
Social Worker - Clinical in Portland, OR

Active since May 11, 2017PECOS Enrolled
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239(503) 494-2273(503) 494-6023 Get Directions Write a Review

NPPES record last updated: October 15, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 20, 2020, Oct 12, 2020, Jun 11, 2019 and 1 more (4 updates tracked since 2017).

About Brenda Bonilla NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRENDA BONILLA (NPI 1003342155) is an individual clinical provider in Portland, Oregon, licensed in Oregon (L11371) and active in the NPI registry since May 2017. She is enrolled in Medicare PECOS and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1003342155
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameBRENDA BONILLA
Location Address3181 SW SAM JACKSON PARK RDPortland, OR 97239-3011
Mailing Address1400 Sw 5th Ave Ste 500Portland, OR 97201-5537 · (866) 617-6855 · Fax (503) 346-8015
Phone(503) 494-2273
Fax(503) 494-6023
Sole ProprietorNo
Enumeration DateMay 11, 2017
Last NPPES UpdateOctober 15, 20244 updates tracked since enumeration
NPPES CertifiedJanuary 8, 2024
✔ NPI 1003342155 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in OR · L11371
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 97763 (CA)
3181 SW SAM JACKSON PARK RD, Portland, OR 97239
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Secondary Practice Locations 3

Location 18019 Compton AveLos Angeles, CA 90001-3409 · Phone (323) 586-7333
Location 21400 S Grand Ave, Suite 600Los Angeles, CA 90015-3048 · Phone (213) 742-6250
Location 33939 Atlantic Ave Ste 103Long Beach, CA 90807-3529 · Phone (562) 264-6001

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Brenda Bonilla is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Brenda Bonilla reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern California Permanente Medical Group
785 mi
Health Maintenance Organization
43112 N 15TH ST
Lancaster, CA 93534
  • Reassigned Medicare billing, California enrollment
  • 13,921 clinicians in this Medicare group
NPI 1982863783 (661) 726-2279

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97239 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $58.99 – $176.88
Typical copayment $0.00 (range $14.74 – $44.22)
Most-billed visit code NA
Established Patient
$73.28 typical visit price
range $19.32 – $144.79
Typical copayment $18.32 (range $4.83 – $36.19)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DONALD RICHARD SULLIVAN MD
Internal Medicine (Pulmonary Disease)
3181 SW SAM JACKSON PARK RD, UHN67
PORTLAND, OR 97239
Multnomah County (503) 494-6949
MRS. ANJALEE NIX ROWE NP
Nurse Practitioner (Acute Care)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-3988
REEM HASAN MD
Internal Medicine
3181 SW SAM JACKSON PARK RD, PPV 350
PORTLAND, OR 97239
Multnomah County (503) 494-8562
DR. AMANDA D BALL PSY.D
Psychologist (Clinical)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-6176
SUNSHINE WELSCH LMT
Massage Therapist
3181 SW SAM JACKSON PARK RD, 7D19
PORTLAND, OR 97239
Multnomah County (503) 494-8349
DR. ROBERT GENE MEALER M.D., PH.D.
Psychiatry & Neurology (Psychiatry)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-6176
GREGORY HALL MD
Radiology (Diagnostic Radiology)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 418-0990
DR. BURHAN AHMED MIAN MD
Student in an Organized Health Care Education/Training Program
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-8311

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brenda Bonilla's NPI number?

The NPI number for Brenda Bonilla is 1003342155. It was assigned to this individual provider in the NPPES registry on May 11, 2017.

Where is Brenda Bonilla located?

Brenda Bonilla practices at 3181 SW Sam Jackson Park Rd, Portland, OR 97239. The listed phone number is (503) 494-2273.

What is Brenda Bonilla's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Brenda Bonilla enrolled in Medicare?

Yes. Brenda Bonilla is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Brenda Bonilla's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Brenda Bonilla reassigns Medicare benefits to Southern California Permanente Medical Group (Lancaster, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Brenda Bonilla's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Brenda Bonilla was last updated on October 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.