Active NPI
Bonelli Eye Care, LLC
- Optometrist
- Canton, CT
National Provider Identifier
1760198253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240202000215 | CT | Part B Supplier - Clinic/Group Practice | 8729431069 |
Receives reassigned benefits from 1 practitioner Practice locations: Canton, CT |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Optometrist
- Canton, CT
- NPI 1154492510
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.