Organization Active NPI

Bonelli Eye Care, LLC

  • Optometrist
  • Canton, CT
National Provider Identifier
1760198253
Registry record updated Jan 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
BONELLI EYE CARE, LLC
Practice address
220 Albany Tpke Unit 5
Canton, CT 06019-7000
Phone
(860) 693-2289
Fax
(860) 693-1835
NPI assigned
Jan 27, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2023

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

Authorized official

Name
Dr. Christioper Bonelli, OD
Title
Owner
Phone
(860) 693-2289

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

220 Albany Tpke Unit 5
Canton, CT 06019-7000

Mailing address

PO Box 14
Canton, CT 06019-0014
Phone (860) 693-2289

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240202000215 CT Part B Supplier - Clinic/Group Practice 8729431069 Receives reassigned benefits from 1 practitioner
Practice locations: Canton, CT

National Provider Directory

National Provider Directory

Locations

220 Albany Tpke
Unit 5
Canton, CT 06019
Phone (860) 693-2289

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1674777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674777600000",
    "number": "1760198253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14",
            "city": "CANTON",
            "state": "CT",
            "postal_code": "060190014",
            "telephone_number": "860-693-2289",
            "fax_number": "860-693-1835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 ALBANY TPKE UNIT 5",
            "city": "CANTON",
            "state": "CT",
            "postal_code": "060197000",
            "telephone_number": "860-693-2289",
            "fax_number": "860-693-1835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONELLI EYE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-27",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-20",
        "status": "A",
        "authorized_official_last_name": "BONELLI",
        "authorized_official_first_name": "CHRISTIOPER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-693-2289",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.