Charles A. Bonelli, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

000763 Issued in CT

Practice address

220 Albany Tpke
Canton Village
Canton, CT 06019-2520

Phone

(860) 639-2289

Fax

(860) 693-1835

NPI assigned

Nov 10, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Bonelli Eye Care, LLC

  • Optometrist
  • Canton, CT
  • NPI 1760198253
  NPD (past)

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154492510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14",
            "address_2": "CANTON VILLAGE",
            "city": "CANTON",
            "state": "CT",
            "postal_code": "060190014",
            "telephone_number": "860-693-2289",
            "fax_number": "860-693-1835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 ALBANY TPKE",
            "address_2": "CANTON VILLAGE",
            "city": "CANTON",
            "state": "CT",
            "postal_code": "060192520",
            "telephone_number": "860-639-2289",
            "fax_number": "860-693-1835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONELLI",
        "first_name": "CHARLES",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "000763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janot Bente, D.M.D.
• Beyond Behavior LLC
• Beyond Rooted LLC
• Christine Biolo
• Bonelli Eye Care, LLC
• Christopher C. Bonelli, O.D.
• Isaac J Bosco, DMD
• Melissa Wooldridge Breton, APRN
• Rebecca Desautels Brickman
• Ian Brokaw, DPT

• Optometrist in Canton, CT
• Providers in Canton, CT by specialty
• Optometrist in Connecticut

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.