Derek John Bonacci, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3170 Issued in MN

Practice address

2055 15TH St N
Saint Cloud, MN 56303-1747

Phone

(320) 251-1432

Fax

(320) 251-7122

NPI assigned

Jul 31, 2009

Sex

Male

Sole proprietor

No

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 MN

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

Specialty

Optometry

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Cloud Eye Clinic PAGroup PAC ID 8325022577, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.55 of 100Reported as group

Quality

91.59

Improvement activities

40

Cost

76.37

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: derek.bonacci.p1@direct.stcloudeyeclinic.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• St Cloud Eye Clinic PA

  • Ophthalmology Physician
  • Saint Cloud, MN
  • NPI 1538157805
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1248998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521072000000",
    "number": "1356572804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 15TH ST N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031747",
            "telephone_number": "320-251-1432",
            "fax_number": "320-251-7122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 15TH ST N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031747",
            "telephone_number": "320-251-1432",
            "fax_number": "320-251-7122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONACCI",
        "first_name": "DEREK",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-31",
        "last_updated": "2018-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Bolland-Hillesheim
• Barbara J Bollinger, MD
• Steven H Bollinger, MD
• Laureen Kay Bollmeyer, PT
• Stephen Bologna
• Michael Bond, CRNA
• Olivia Lee Bond
• Kailly Allyce Bonnett, MS LADC LPCC
• Cole Bonovsky
• Jodi Ann Boos, LADC

• Optometrist in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2018; 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.