Individual provider Active NPI

Leah Marie Bohnert, OD

  • Optometrist
  • Fort Worth, TX
National Provider Identifier
1467932558
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9533T Issued in TX
Practice address
9429 N Beach St
Fort Worth, TX 76244-9059
Phone
(817) 442-2020
Fax
(682) 499-3856
NPI assigned
Aug 17, 2018
Last updated
Dec 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9533T TX Primary

Addresses

Primary practice location

9429 N Beach St
Fort Worth, TX 76244-9059

Mailing address

9429 N Beach St
Fort Worth, TX 76244-9059
Phone (817) 442-2020

Other practice location 1

1680 FM 407 #100
Northlake, TX 76247
Phone (817) 442-2020

Other practice location 2

1705 S Fm 51 Ste 104
Decatur, TX 76234-3646
Phone (817) 442-2020

Other practice location 3

171 W Southlake Blvd Unit 5B
Southlake, TX 76092-6304
Phone (817) 442-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20200304001493 TX Practitioner - Optometry 2264778760 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alliance Ophthalmology, PLLCGroup PAC ID 9537441357, 6 clinicians

Practice addresses (Care Compare)

9429 N Beach St
Fort Worth, TX 76244-9059
Phone (817) 442-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9533TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Eye and Ear PLLC CurrentSince Jan 1, 2021 Accepting new patients
Dallas Eye and Ear Optical, PLLC Optometrist CurrentSince Jan 1, 2021 Accepting new patients
Alliance Ophthalmology, PLLC CurrentSince Mar 6, 2023 Accepting new patients
Optio, PLLC Optometrist PastSince Aug 2, 2021 Accepting new patients
Alliance Retina of Texas, PLLC PastSince Mar 6, 2023 Accepting new patients

Locations

10740 N Central Expy
Ste 120
Dallas, TX 75231
Phone (214) 361-5285

1703 N Beckley Ave
Dallas, TX 75203
Phone (214) 361-5285

1705 S FM 51
Ste 104
Decatur, TX 76234
Phone (817) 442-2020

9429 N Beach St
Fort Worth, TX 76244
Phone (817) 442-2020

1680 FM 407
Ste 100
Northlake, TX 76247
Phone (817) 442-2020

171 W Southlake Blvd
Ste 140
Southlake, TX 76092

171 W Southlake Blvd
Unit 5B
Southlake, TX 76092
Phone (817) 442-2020

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1534464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1467932558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9429 N BEACH ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762449059",
            "telephone_number": "817-442-2020",
            "fax_number": "682-499-3856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9429 N BEACH ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762449059",
            "telephone_number": "817-442-2020",
            "fax_number": "682-499-3856"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1680 FM 407 #100",
            "address_purpose": "LOCATION",
            "city": "NORTHLAKE",
            "state": "TX",
            "postal_code": "76247",
            "country_code": "US",
            "telephone_number": "817-442-2020",
            "fax_number": "682-499-3856",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1705 S Fm 51 Ste 104",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "TX",
            "postal_code": "762343646",
            "country_code": "US",
            "telephone_number": "817-442-2020",
            "fax_number": "682-499-3856",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "171 W Southlake Blvd Unit 5B",
            "address_purpose": "LOCATION",
            "city": "Southlake",
            "state": "TX",
            "postal_code": "760926304",
            "country_code": "US",
            "telephone_number": "817-442-2020",
            "fax_number": "682-499-3856",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOHNERT",
        "first_name": "LEAH",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-17",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9533T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.