1. Home
  2. Directory
  3. New York
  4. Lindenhurst
  5. Internal Medicine
  6. NPI Profile

JORGE BONILLA MD PC
NPI 1669038329
Internal Medicine in Lindenhurst, NY

Active since May 17, 2019CLIA 33D2168750 · Waiver
191 W HOFFMAN AVE, LINDENHURST, NY 11757(631) 608-4741(631) 608-4742 Get Directions Write a Review

NPPES record last updated: August 15, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 15, 2023, Dec 10, 2019, Jul 8, 2019 and 1 more (4 updates tracked since 2019).

About Jorge Bonilla Md Pc NPPES

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

JORGE BONILLA MD PC (NPI 1669038329) is a healthcare organization registered as an internal medicine in Lindenhurst, New York and active in the NPI registry since May 2019. The organization holds a CLIA Waiver certificate valid through July 8, 2027 and lists Jorge Bonilla, Md, as its authorized official.

NPPES Registry Identity

NPI1669038329
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameJORGE BONILLA MD PC
Location Address191 W HOFFMAN AVELindenhurst, NY 11757-4036
Mailing Address116 Broadway Ste 1Amityville, NY 11701-2797 · (631) 608-4741
Phone(631) 608-4741
Fax(631) 608-4742
Organization SubpartNo
Authorized OfficialJorge BonillaMd · (631) 608-4741
Enumeration DateMay 17, 2019
Last NPPES UpdateAugust 15, 20234 updates tracked since enumeration
NPPES CertifiedAugust 15, 2023
✔ NPI 1669038329 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
191 W HOFFMAN AVE, Lindenhurst, NY 11757
Open in Google Maps ↗

Other Identifiers 1

Other264692NY · License

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Jorge Bonilla MD PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jorge Bonilla, M.D
Internal Medicine
NPI 1376834176
191 W HOFFMAN AVE
Lindenhurst, NY 11757
(631) 608-4741
✔ PECOS✔ Accepts MedicareSame address

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2168750

Jorge Bonilla MD PC · Amityville, NY
Active · expires Jul 8, 2027
CLIA Number33D2168750
Laboratory TypePhysician Office
Certificate Effective DateJuly 9, 2025
Certificate Expiration DateJuly 8, 2027
Laboratory DirectorJorge L. Bonilla
Laboratory Phone(631) 608-4741
Laboratory LocationJorge Bonilla MD PC116 Broadway - Suite 1, Amityville, NY 11701
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Jorge Bonilla MD PC's NPI number?

The NPI number for Jorge Bonilla MD PC is 1669038329. It was assigned to this organization in the NPPES registry on May 17, 2019.

Where is Jorge Bonilla MD PC located?

Jorge Bonilla MD PC is located at 191 W Hoffman Ave, Lindenhurst, NY 11757. The listed phone number is (631) 608-4741.

What is Jorge Bonilla MD PC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Jorge Bonilla MD PC enrolled in Medicare?

Yes. Jorge Bonilla MD PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Jorge Bonilla MD PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Jorge Bonilla MD PC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Jorge Bonilla MD PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2168750) is associated with this NPI, valid through July 8, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Jorge Bonilla MD PC was last updated on August 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.