Individual provider Active NPI

John-Michael Joseph Bona, O.D.

  • Optometrist
  • Marblehead, MA
National Provider Identifier
1003977661
Registry record updated Sep 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3656 Issued in MA
Practice address
1 Widger Rd
Marblehead, MA 01945-2146
Phone
(781) 631-8300
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3656 MA Primary

Addresses

Primary practice location

1 Widger Rd
Marblehead, MA 01945-2146

Mailing address

1 Widger Rd
Marblehead, MA 01945-2146
Phone (781) 631-8300

Other identifiers 1

IdentifierTypeStateIssuer
0371530MedicaidMA

Other names 1

  • Dr. John M Bona Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101027000060 MA Practitioner - Optometry 8527252238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Redstone Eye Associates LLCGroup PAC ID 7517911092, 5 clinicians

Practice addresses (Care Compare)

75 Main St
Stoneham, MA 02180-3305
Phone (781) 438-3372

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3656MAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Redstone Eye Associates, LLC Optometrist CurrentSince Jan 1, 2021 Accepting new patients

Locations

75 Main St
Stoneham, MA 02180
Phone (781) 438-2505

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473811200000",
    "number": "1003977661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WIDGER RD",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "019452146",
            "telephone_number": "781-631-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WIDGER RD",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "019452146",
            "telephone_number": "781-631-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONA",
        "first_name": "JOHN-MICHAEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2016-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "3656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0371530",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "BONA",
            "middle_name": "M",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Marblehead, MA

Sources for this page

Verify at the official NPI Registry.