Karen Grante Bonnanzio, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

002346 Issued in CT

Practice address

7365 Main St
Stratford, CT 06614-1300

Phone

(203) 377-3937

Fax

(888) 741-0620

NPI assigned

Oct 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in CT

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

New England College of Optometry, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oec Waterbury LLC 3 clinicians

Oec Derby LLC 4 clinicians

Oronoque Eye Care Inc. 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Oec Waterbury LLC

  • Optometrist
  • Waterbury, CT
  • NPI 1477097285

  CT, Optometrist

  Medicare reassignment Care Compare group NPD Authorized official
• Oec Derby LLC

  • Optometrist
  • Derby, CT
  • NPI 1275287005

  CT, Optometrist

  Medicare reassignment Care Compare group NPD
• Oronoque Eye Care Inc.

  • Optometrist
  • Stratford, CT
  • NPI 1801834247

  CT, Optometrist

  Medicare reassignment Care Compare group NPD
• Peter J. Stein LLC

  • Eyewear Supplier
  • Derby, CT
  • NPI 1326216771
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476316800000",
    "number": "1508955873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7365 MAIN ST",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066141300",
            "telephone_number": "203-377-3937",
            "fax_number": "888-741-0620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7365 MAIN ST",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066141300",
            "telephone_number": "203-377-3937",
            "fax_number": "888-741-0620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNANZIO",
        "first_name": "KAREN",
        "middle_name": "GRANTE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2016-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "002346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004160983",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "020346",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "50ORONOQUCT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "1040121",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "115529",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0297743",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "1801834247",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "204142248",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Bernice Bova, RN
• Kyle Bowrin, MD, MPH
• Caroline Braglia

• All providers in Stratford, CT
• Optometrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2016; 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.