Individual provider Active NPI

Kathryn H Bony, OD

  • Optometrist
  • Norwich, CT
National Provider Identifier
1013997923
Registry record updated Jun 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
002228 Issued in CT
Practice address
79 Wawecus St
Suite 105
Norwich, CT 06360-2160
Phone
(860) 886-0161
Fax
(860) 889-5999
NPI assigned
Jan 18, 2006
Last updated
Jun 14, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 002228 CT Primary

Addresses

Primary practice location

79 Wawecus St
Suite 105
Norwich, CT 06360-2160

Mailing address

79 Wawecus St
Suite 105
Norwich, CT 06360-2160
Phone (860) 886-0161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20110627000385 CT Practitioner - Optometry 4981659679 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crystal Vision, LLCGroup PAC ID 2466525043, 3 clinicians

Practice addresses (Care Compare)

909 Hartford Tpke
Suite D2
Waterford, CT 06385-4267
Phone (860) 442-0380

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2228CTMDClinical Social Worker
3528MAMDAthletic Trainer
002228CTMDPsychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Connecticut, LLC Optometrist CurrentSince Aug 1, 2022 Accepting new patients
Myeyedr Optometry of Connecticut, LLC Optometrist Current Accepting new patients
Crystal Vision, LLC Optometrist CurrentSince Nov 1, 2021 Accepting new patients
Myeyedr Optometry of Connecticut, LLC Optometrist CurrentSince Aug 1, 2022 Accepting new patients
Crystal Vision West Hartford LLC. Optometrist PastSince Nov 1, 2021 Accepting new patients

Locations

145 Wakelee Ave
Ansonia, CT 06401
Phone (203) 734-1686

909 Hartford Tpke
Ste D2
Waterford, CT 06385
Phone (860) 442-0380

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308009600000",
    "number": "1013997923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 WAWECUS ST",
            "address_2": "SUITE 105",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602160",
            "telephone_number": "860-886-0161",
            "fax_number": "860-889-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 WAWECUS ST",
            "address_2": "SUITE 105",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602160",
            "telephone_number": "860-886-0161",
            "fax_number": "860-889-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONY",
        "first_name": "KATHRYN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-18",
        "last_updated": "2011-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "002228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, CT

Sources for this page

Verify at the official NPI Registry.