Individual provider Active NPI

Abbey J Bonnell, OD

  • Optometrist
  • Bellefonte, PA
National Provider Identifier
1306109087
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG002621 Issued in PA
Practice address
205 Park PL
Bellefonte, PA 16823-2557
Phone
(866) 995-3937
NPI assigned
Jun 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG002621 PA Primary

Addresses

Primary practice location

205 Park PL
Bellefonte, PA 16823-2557

Mailing address

88 Hardees Dr
Mifflinburg, PA 17844-7062
Phone (570) 966-5582

Other practice location 1

435 River Ave
Williamsport, PA 17701-3722
Phone (570) 326-8070

Other identifiers 1

IdentifierTypeStateIssuer
102768606-0003MedicaidPA

Other names 1

  • Abbey R Johnson Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ABonnell@eccpa.ecldirect.net Direct BERNSTEIN, HILLIKER, HARTZELL EYE CENTER, LLP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20120720000239 PA Practitioner - Optometry 4587820451 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

205 Park PL
Bellefonte, PA 16823-2557
Phone (866) 995-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG002621PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bernstein Hilliker Hartzell Eye Center LLP CurrentSince Jul 1, 2012 Accepting new patients
Bernstein, Hilliker, Hartzell Eye Center, LLP Optometrist CurrentSince Jul 1, 2012 Accepting new patients
Bernstein Hilliker Hartzell Eye Center, LLP Optometrist Past Accepting new patients

Locations

205 Park Pl
Bellefonte, PA 16823
Phone (814) 548-0603

137 Jpm Rd
Lewisburg, PA 17837
Phone 5705233288105

88 Hardees Dr
Mifflinburg, PA 17844
Phone (570) 538-6002

435 River Ave
Williamsport, PA 17701
Phone (570) 326-8070

Interoperability endpoints

  • Direct secure messaging: abonnell@eccpa.ecldirect.net
  • Direct secure messaging: abonnell@eccpa.intellechartdirect.net

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1306109087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 HARDEES DR",
            "city": "MIFFLINBURG",
            "state": "PA",
            "postal_code": "178447062",
            "telephone_number": "570-966-5582",
            "fax_number": "570-966-5586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 PARK PL",
            "city": "BELLEFONTE",
            "state": "PA",
            "postal_code": "168232557",
            "telephone_number": "866-995-3937"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "435 River Ave",
            "address_purpose": "LOCATION",
            "city": "Williamsport",
            "state": "PA",
            "postal_code": "177013722",
            "country_code": "US",
            "telephone_number": "570-326-8070",
            "fax_number": "570-326-0396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONNELL",
        "first_name": "ABBEY",
        "middle_name": "J",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-19",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG002621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102768606-0003",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ABonnell@eccpa.ecldirect.net",
            "affiliation": "Y",
            "affiliationName": "BERNSTEIN, HILLIKER, HARTZELL EYE CENTER, LLP",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "205 Park Pl",
            "city": "Bellefonte",
            "state": "PA",
            "country_code": "US",
            "postal_code": "168232557",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ABBEY",
            "last_name": "JOHNSON",
            "middle_name": "R",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bellefonte, PA

Sources for this page

Verify at the official NPI Registry.