Mr Xavier Antonio Bonilla, PHD in New Market, MD - Medicare Psychologist Provider

Mr Xavier Antonio Bonilla, PHD is a medicare enrolled "Psychologist" provider in New Market, Maryland. His current practice location is 4 W Main St, New Market, Maryland. You can reach out to his office (for appointments etc.) via phone at (301) 381-4586.

Mr Xavier Antonio Bonilla is licensed to practice in Maryland (license number 07314) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1922384999.

Contact Information

	Mr Xavier Antonio Bonilla, PHD
	4 W Main St, New Market, MD 21774-6290
	(301) 381-4586
	(240) 563-0460

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Xavier Antonio Bonilla
Gender	Male
Speciality	Psychologist
Location	4 W Main St, New Market, Maryland
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1922384999
Provider Enumeration Date: 10/22/2011
Last Update Date: 09/04/2025

Medicare PECOS Information:

PECOS PAC ID: 8820460256
Enrollment ID: I20250212003270

Medical Identifiers

Medical identifiers for Mr Xavier Antonio Bonilla such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1922384999	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103T00000X	Psychologist	07314 (Maryland)	Primary
101YM0800X	Counselor - Mental Health	LC4176 (Maryland)	Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Xavier Antonio Bonilla allows following entities to bill medicare on his behalf.

Entity Name	Green Valley Therapy, L.l.c.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1457069858 PECOS PAC ID: 1850738493 Enrollment ID: O20240319001961

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Xavier Antonio Bonilla is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Xavier Antonio Bonilla, PHD 4 W Main St, New Market, MD 21774-6290 Ph: (301) 381-4586	Mr Xavier Antonio Bonilla, PHD 4 W Main St, New Market, MD 21774-6290 Ph: (301) 381-4586

Reviews and Comments

Psychologist in New Market, MD

Mrs. Jennifer Luhrs Perone, M.A. CAGS Psychologist Medicare: Not Enrolled in Medicare Practice Location: 125 W Main St, New Market, MD 21774 Phone: 227-203-2400
Dr. Rollo Warren Jones Jr., Psychologist Medicare: Not Enrolled in Medicare Practice Location: 10707 Grangerford Ct, New Market, MD 21774 Phone: 240-439-0627
Dr. Anjali Jain, PH.D. Psychologist Medicare: Medicare Enrolled Practice Location: 11247 Country Club Rd, New Market, MD 21774 Phone: 240-457-9830

Mr Xavier Antonio Bonilla, PHD - Medicare Psychologist in New Market, MD