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

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: October 25, 2026.

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

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, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Juan Samuel Bonilla-perez reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Oak Street Health Of New York Medical Group PC
1.9 mi
Primary Care
455 SUTTER AVE
Brooklyn, NY 11212
  • Reassigned Medicare billing, New York enrollment
  • Medicare enrollment name: Griffin Myers Medical PC
  • 101 clinicians in this Medicare group
NPI 1780209445 (718) 765-6550
Hpm Foundation Inc
Federally Qualified Health Center (FQHC)
1400 CALLE DOVER, CAPARRA TERRACE
San Juan, PR 00920
  • Reassigned Medicare billing, Puerto Rico enrollment
  • 68 clinicians in this Medicare group
NPI 1023730504 (787) 705-6771

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 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
1114 LIBERTY AVE
BROOKLYN, NY 11208
Kings County (718) 765-6058
MELISSA GOMEZ
Nurse Practitioner (Family)
1114 LIBERTY AVE
BROOKLYN, NY 11208
Kings County (718) 765-6058
MRS. SHAWN ANDREA TAPPER FNP
Nurse Practitioner (Family)
1114 LIBERTY AVE
BROOKLYN, NY 11208
Kings County (718) 765-6058
DANIEL TRAVIS MD
Family Medicine
1114 LIBERTY AVE
BROOKLYN, NY 11208
Kings County (718) 765-6058
NIAMBI BROWN M.D.
Family Medicine
1114 LIBERTY AVE
BROOKLYN, NY 11208
Kings County (718) 765-6058
DARIN A PORTNOY MD
Family Medicine
1114 LIBERTY AVE
BROOKLYN, NY 11208
Kings County (718) 765-6058
JUSTIN TORRENTE M.D.
Family Medicine
1114 LIBERTY AVE
BROOKLYN, NY 11208
Kings County (718) 765-6058
JADA CEMONE ALBRIGHT
Counselor (Mental Health)
1114 LIBERTY AVE
BROOKLYN, NY 11208
Kings County (718) 765-6058

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 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.

Where is Juan Samuel Bonilla-perez located?

Juan Samuel Bonilla-perez practices at 1114 Liberty Ave, Brooklyn, NY 11208. The listed phone number is (718) 765-6058.

What is Juan Samuel Bonilla-perez's specialty?

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

Is Juan Samuel Bonilla-perez enrolled in Medicare?

Yes. Juan Samuel Bonilla-perez is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Juan Samuel Bonilla-perez's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Juan Samuel Bonilla-perez reassigns Medicare benefits to 2 organizations: Oak Street Health Of New York Medical Group PC (Brooklyn, NY) and Hpm Foundation Inc (San Juan, PR). Each 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 Juan Samuel Bonilla-perez'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 Juan Samuel Bonilla-perez was last updated on July 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.