Individual provider Active NPI

William Gerald Bosley III, O.D.

  • Optometrist
  • Moorefield, WV
National Provider Identifier
1770516320
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1023 Issued in WV
Practice address
8 Lee St
Suite 134
Moorefield, WV 26836-1091
Phone
(304) 538-5930
Fax
(304) 538-5931
NPI assigned
Jul 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1023 WV Primary

Addresses

Primary practice location

8 Lee St
Suite 134
Moorefield, WV 26836-1091

Mailing address

8 Lee St
Suite 134
Moorefield, WV 26836-1091
Phone (304) 538-5930

Other identifiers 1

IdentifierTypeStateIssuer
3810003727MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20051010000726 WV Practitioner - Optometry 6305816844 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bosley Eye Care Inc 2 clinicians

Practice addresses (Care Compare)

8 Lee St
Suite 134
Moorefield, WV 26836-1091
Phone (304) 538-5930

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery30

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1023WVMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bosley Eye Care, Inc. Optometrist CurrentSince Oct 1, 2005 Accepting new patients
Bosley Eye Care, Inc. CurrentSince Oct 1, 2005 Accepting new patients
Sites Vision Clinic Optometrist PastSince Jan 1, 2011 Accepting new patients
Sites Vision Clinic Optometrist Past Accepting new patients
M F Anwar MD Inc Optometrist Past Accepting new patients

Locations

8 Lee St
Ste 134
Moorefield, WV 26836
Phone (304) 538-5930

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770516320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 LEE ST",
            "address_2": "SUITE 134",
            "city": "MOOREFIELD",
            "state": "WV",
            "postal_code": "268361091",
            "telephone_number": "304-538-5930",
            "fax_number": "304-538-5931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 LEE ST",
            "address_2": "SUITE 134",
            "city": "MOOREFIELD",
            "state": "WV",
            "postal_code": "268361091",
            "telephone_number": "304-538-5930",
            "fax_number": "304-538-5931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSLEY",
        "first_name": "WILLIAM",
        "middle_name": "GERALD",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WV",
            "license": "1023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810003727",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorefield, WV

Sources for this page

Verify at the official NPI Registry.