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CARLOS EDUARDO BONILLA APRN
NPI 1174032122
Nurse Practitioner - Family in Orem, UT

Active since September 21, 2017PECOS Enrolled
1443 WEST 800 NORTH, SUITE #302, OREM, UT 84057(801) 235-0953 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 17, 2018, Sep 21, 2017 (2 updates tracked since 2017).

About Carlos Eduardo Bonilla Aprn NPPES

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

CARLOS EDUARDO BONILLA APRN (NPI 1174032122) is an individual family provider in Orem, Utah, licensed in Utah (5250948-4405) and active in the NPI registry since September 2017. He is enrolled in Medicare PECOS and maintains a secondary practice location in Salt Lake City.

NPPES Registry Identity

NPI1174032122
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameCARLOS EDUARDO BONILLACredential: APRN
Location Address1443 WEST 800 NORTH, SUITE #302Orem, UT 84057-3658
Mailing Address3527 Newland LoopLehi, UT 84043-4617 · (801) 592-9350
Phone(801) 235-0953
Sole ProprietorYes
Enumeration DateSeptember 21, 2017
Last NPPES UpdateMarch 17, 20182 updates tracked since enumeration
✔ NPI 1174032122 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in UT · 5250948-4405
1443 WEST 800 NORTH, SUITE #302, Orem, UT 84057
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Other Names 1

Professional Name (2)Carlos Eduardo Bonilla Aprn

Secondary Practice Location 1

Location 1George E. Wahlen VA Salt Lake City Health Care System, 500 Foothill Blvd. (00QC)Salt Lake City, UT 84138 · Phone (801) 582-1565 ext. 2062

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Carlos Eduardo Bonilla Aprn 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84057 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
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$96.35 typical visit price
range $17.23 – $135.20
Typical copayment $24.08 (range $4.30 – $33.80)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Carlos Bonilla's NPI number?

The NPI number for Carlos Bonilla is 1174032122. It was assigned to this individual provider in the NPPES registry on September 21, 2017. The provider is also known as Carlos Eduardo Bonilla Aprn.

Where is Carlos Bonilla located?

Carlos Bonilla practices at 1443 West 800 North, Suite #302, Orem, UT 84057. The listed phone number is (801) 235-0953.

What is Carlos Bonilla's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Carlos Bonilla enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Carlos Bonilla was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.