Staci Anne Boon, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

072761 Issued in IA

Practice address

909 E San Marnan Dr
Waterloo, IA 50702-5611

Phone

(319) 233-2020

Fax

(319) 234-1939

NPI assigned

Nov 5, 2012

Last updated

Mar 10, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IA

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cedar Valley Medical Specialists PCGroup PAC ID 1759291487, 61 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Cedar Valley Medical Specialists PC

  • Orthopaedic Surgery Physician
  • Waterloo, IA
  • NPI 1497794242

  Optometrist

  Medicare reassignment Care Compare group NPD
• Cedar Valley Medical Specialists PC

  • Durable Medical Equipment & Medical Supplies
  • Vinton, IA
  • NPI 1659934180
  NPD
• Cedar Valley Medical Specialists PC

  • Durable Medical Equipment & Medical Supplies
  • Waverly, IA
  • NPI 1073567780
  NPD (past)
• Cedar Valley Medical Specialists, PC

  • Durable Medical Equipment & Medical Supplies
  • Cedar Falls, IA
  • NPI 1154749208
  NPD (past)

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

{
    "created_epoch": "1352073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1013261510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2758",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507042758",
            "telephone_number": "319-235-5390",
            "fax_number": "319-235-5607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 E SAN MARNAN DR",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025611",
            "telephone_number": "319-233-2020",
            "fax_number": "319-234-1939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOON",
        "first_name": "STACI",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-05",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "072761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "staci.boon@cvms.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "CVMS",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "909 E San Marnan Dr",
            "city": "Waterloo",
            "state": "IA",
            "country_code": "US",
            "postal_code": "507025611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• William C Bolick, D.D.S.
• Amy R Bonebrake, LMSW, CADC, SAP
• Ted Arthur Bonebrake, M.D.
• Abigail Jo Bonner
• Heidi M Bonthuis, PA--C
• Kimberly A Boote, C.N.M.
• Britney Borcherding
• Theresa Rae Borcherding, ARNP
• Ryan Norman Borgwardt, D.D.S.
• Teresa Boring

• Optometrist in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.