Christopher J Bobeczko, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4726 Issued in OH

Practice address

7401 Market St
Boardman, OH 44512-5639

Phone

(330) 758-5671

NPI assigned

Feb 8, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH, PA2 enrollments

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 2

Specialty

Optometry

Education

Ohio State University - College of Optometry, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093856692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 ONYX PL",
            "city": "CORTLAND",
            "state": "OH",
            "postal_code": "444101904",
            "telephone_number": "330-637-6102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7401 MARKET ST",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445125639",
            "telephone_number": "330-758-5671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBECZKO",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED PROVIDER ID",
            "identifier": "810198",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Boardman Clinic
• Boardman Dialysis Center LLC
• Boardman Local School District
• Boardman Medical Supply Co
• Boardman Township Trustees
• Raymond Boggs Jr
• Danielle Boggs
• Dominique Elyse Bonamase, COUNSELING TRAINEE
• Boniface Orthopaedics, Inc.
• Mia Bonilla, LPN

• Optometrist in Boardman, OH
• Providers in Boardman, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.