Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JUAN SAMUEL IGNACIO BONILLA-PEREZ M.D.
NPI 1205039757
Family Medicine in Brooklyn, NY

Q: What is Juan Samuel Bonilla-perez's NPI number?

The NPI number for Juan Samuel Bonilla-perez is 1205039757. It was assigned to this individual provider in the NPPES registry on June 11, 2007.

Q: What is Juan Samuel Bonilla-perez's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since June 11, 2007PECOS Enrolled

1114 LIBERTY AVE, BROOKLYN, NY 11208(718) 765-6058(347) 808-4895 Get Directions Write a Review

NPPES record last updated: July 29, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jul 29, 2026, Apr 6, 2021, May 24, 2019 and 2 more (5 updates tracked since 2019).

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About Juan Samuel Ignacio Bonilla-perez M.d. NPPES

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

JUAN SAMUEL IGNACIO BONILLA-PEREZ M.D. (NPI 1205039757) is an individual family medicine provider in Brooklyn, New York, licensed in New York (292251) and active in the NPI registry since June 2007. He is enrolled in Medicare PECOS and maintains a secondary practice location in San Juan.

NPPES Registry Identity

NPI1205039757

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameJUAN SAMUEL IGNACIO BONILLA-PEREZCredential: M.D.

Location Address1114 LIBERTY AVEBrooklyn, NY 11208-2922

Mailing AddressPo Box 746087Atlanta, GA 30374-6087 · (833) 804-1695

Phone(718) 765-6058

Fax(347) 808-4895

Sole ProprietorYes

Enumeration DateJune 11, 2007

Last NPPES UpdateJuly 29, 20265 updates tracked since enumeration

NPPES CertifiedJuly 29, 2026

✔ NPI 1205039757 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in NY · 292251

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedFamily Medicine · Geriatric MedicineTaxonomy 207QG0300X · License 16664 (PR), MD048978 (DC)

1114 LIBERTY AVE, Brooklyn, NY 11208

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Secondary Practice Location 1

Location 12020 Ave Borinquen, Barrio ObreroSan Juan, PR 00915 · Phone (787) 268-4171 ext. 5012

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Juan Samuel Ignacio Bonilla-perez M.d. 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 11208 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

$105.06 typical visit price

range $67.40 – $203.53

Typical copayment $26.26 (range $16.85 – $50.88)

Most-billed visit code 99203

Established Patient

$117.62 typical visit price

range $21.66 – $164.45

Typical copayment $29.40 (range $5.41 – $41.11)

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.

Other Providers at the Same Location NPPES 8

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

DR. SARA ILANA FONTANEZ M.D.

Family Medicine