JOEL BONILLA-LARSEN MD
NPI 1063899243
Student in an Organized Health Care Education/Training Program in Sacramento, CA

Q: What is Joel Bonilla-larsen's NPI number?

The NPI number for Joel Bonilla-larsen is 1063899243. It was assigned to this individual provider in the NPPES registry on April 27, 2015.

Q: What is Joel Bonilla-larsen's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since April 27, 2015PECOS Enrolled

4860 Y ST STE 1600, SACRAMENTO, CA 95817(916) 734-3630 Get Directions Write a Review

NPPES record last updated: April 27, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Joel Bonilla-larsen Md NPPES

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

JOEL BONILLA-LARSEN MD (NPI 1063899243) is an individual student in an organized health care education/training program in Sacramento, California and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1063899243

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameJOEL BONILLA-LARSENCredential: MD

Location Address4860 Y ST STE 1600Sacramento, CA 95817-2307

Mailing Address4860 Y St Ste 1600Sacramento, CA 95817-2307

Phone(916) 734-3630

Sole ProprietorYes

Enumeration DateApril 27, 2015

✔ NPI 1063899243 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

4860 Y ST STE 1600, Sacramento, CA 95817

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Joel Bonilla-larsen Md 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.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

1 supplier20 claims20 services$50.96 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

1 supplier20 claims20 services$26.30 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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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.

CAMILLE B MADISON MD

Family Medicine