Marques Joseph Bostic, O.D

Primary specialty

OptometristTaxonomy code 152W00000X

License

34454TLG Issued in CA

Practice address

1179 N McDowell Blvd
Petaluma, CA 94954-6559

Phone

(707) 559-7500

Fax

(707) 559-7707

NPI assigned

Jun 22, 2010

Last updated

Jul 1, 2026By 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 5

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, HI, MN3 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 3

Specialty

Optometry

Education

State University of New York - State College Optometry, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Petaluma Health Center IncGroup PAC ID 9133180375, shared by 8 NPIs, 76 clinicians

Lanai Community Health CenterGroup PAC ID 5395828925, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CCECCA

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.

• Lanai Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Lanai City, HI
  • NPI 1679754097
  Medicare reassignment Care Compare group NPD
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Woodlake, CA
  • NPI 1164517744
  Medicare reassignment NPD
• San Luis Obispo Eye Associates, a Medical Group Inc

  • Ophthalmology Physician
  • Templeton, CA
  • NPI 1366409898

  Optometrist

  Medicare reassignment NPD
• Eyemd on Cass a Professional Corporation

  • Optometrist
  • Monterey, CA
  • NPI 1205095742
  Medicare reassignment
• Fifth Optometric Care of California

  • Optometrist
  • San Jose, CA
  • NPI 1215627914
  Medicare reassignment
• Total Vision PC

  dba Total Vision

  • Optometrist
  • San Diego, CA
  • NPI 1356813711
  Medicare reassignment
• Troy Humphreys OD Faao, Professional Corporation

  dba Legacy Optometry

  • Optometrist
  • Susanville, CA
  • NPI 1326660960
  Medicare reassignment
• Eagan Eye Clinic LLC

  • Optometrist
  • Eagan, MN
  • NPI 1477732337
  Medicare reassignment
• Visionworks, Inc.

  dba Visionworks

  • Optometrist
  • Austin, MN
  • NPI 1881962173
  Medicare reassignment
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Pixley, CA
  • NPI 1033661558
  NPD
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Delano, CA
  • NPI 1063283158
  NPD
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Porterville, CA
  • NPI 1083611156
  NPD

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

{
    "created_epoch": "1277164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1265753404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1179 N MCDOWELL BLVD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949546559",
            "telephone_number": "707-559-7500",
            "fax_number": "707-559-7707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1179 N MCDOWELL BLVD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949546559",
            "telephone_number": "707-559-7500",
            "fax_number": "707-559-7707"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "65 N Hockett St",
            "address_purpose": "LOCATION",
            "city": "Porterville",
            "state": "CA",
            "postal_code": "93257",
            "country_code": "US",
            "telephone_number": "559-639-6300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOSTIC",
        "first_name": "MARQUES",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-22",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ME",
            "license": "OPT910",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "AT4823",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-002961",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34454TLG",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "HI",
            "license": "OD1060",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Boracchia & Associates
• Eric Borchardt, BCBA
• Kristin Elizabeth Bordessa, RDN, LD
• Magin Delgado Borrajo, PH.D., MFT
• Louise M Bortolotti
• Hope Lovena Bottini
• Brian Bouch, M.D.
• Larry Howard Lee Bowen, ARRT(R) EMT(B)
• Nicole Bowman
• Rob Bowman, LMFT

• Optometrist in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; 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.