NPIMap

Individual provider Active NPI

Dean J Bonsall, M.D.

  • Ophthalmology Physician
  • Winston Salem, NC
National Provider Identifier
1326071648
Registry record updated Jul 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
2018-02030 Issued in NC
Practice address
Medical Center Blvd
Winston Salem, NC 27157-9193
Phone
(336) 716-1322
NPI assigned
Jul 9, 2006
Last updated
Jul 2, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 35.086275 OH
Ophthalmology Physician 207W00000X 24355 WV
Ophthalmology Physician 207W00000X 2018-02030 NC Primary
Pediatrics Physician 208000000X 35-08-6275 OH

Addresses

Primary practice location

Medical Center Blvd
Winston Salem, NC 27157-9193

Mailing address

PO Box 780
1 Stadium Drive
Morgantown, WV 26507-0780
Phone (304) 285-7101

Other identifiers 1

IdentifierTypeStateIssuer
3810004592MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181114003327 NC Practitioner - Ophthalmology 9638108749 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Pennsylvania State University College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.086275OHMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Oct 1, 2018 Accepting new patients
Wake Forest Health Network, LLC Pediatrics CurrentSince Nov 4, 2018 Accepting new patients
Wake Forest Health Network LLC Ophthalmology CurrentSince Nov 4, 2018 Accepting new patients
Wake Forest Health Network LLC Pediatrics Current Accepting new patients

Locations

329 NC Highway 801 N
Bermuda Run, NC 27006
Phone (336) 716-8200

2519 Oakcrest Ave
Greensboro, NC 27408
Phone (336) 271-2007

1565 N University Pkwy
High Point, NC 27262
Phone (336) 802-2020

905 Phillips Ave
High Point, NC 27262
Phone (336) 802-2040

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1326071648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 780",
            "address_2": "1 STADIUM DRIVE",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265070780",
            "telephone_number": "304-285-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271579193",
            "telephone_number": "336-716-1322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONSALL",
        "first_name": "DEAN",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35.086275",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WV",
            "license": "24355",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "2018-02030",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35-08-6275",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810004592",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.