Individual provider Active NPI

Tamara Lynn Bonnes-Heil, O.D.

  • Optometrist
  • Grand Island, NE
National Provider Identifier
1811034713
Registry record updated Dec 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
NE 1041 Issued in NE
Practice address
724 N Diers Ave
Grand Island, NE 68803-4954
Phone
(308) 384-9505
Fax
(308) 384-4939
NPI assigned
Jan 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NE 1041 NE Primary
Corneal and Contact Management Optometrist 152WC0802X NE 1041 NE
Pediatric Optometrist 152WP0200X NE 1041 NE
Vision Therapy Optometrist 152WV0400X NE 1041 NE

Addresses

Primary practice location

724 N Diers Ave
Grand Island, NE 68803-4954

Mailing address

724 N Diers Ave
Grand Island, NE 68803-4954
Phone (308) 384-9505

Other identifiers 2

IdentifierTypeStateIssuer
10025072000MedicaidNE
36335OtherNEBLUE CROSS BLUE SHIELD NE

Other names 1

  • Dr. Tamara Lynn Bonnes Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20040624000307 NE Practitioner - Optometry 1254316672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

724 N Diers Ave
Grand Island, NE 68803-4954
Phone (308) 384-9505

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1041NEMDMental Health Counselor
NE 1041NEMDOptometrist

Organizations & group practices 1

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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386633600000",
    "number": "1811034713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 N DIERS AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034954",
            "telephone_number": "308-384-9505",
            "fax_number": "308-384-4939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 N DIERS AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034954",
            "telephone_number": "308-384-9505",
            "fax_number": "308-384-4939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNES-HEIL",
        "first_name": "TAMARA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2013-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "NE 1041",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NE",
            "license": "NE 1041",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "NE",
            "license": "NE 1041",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "NE",
            "license": "NE 1041",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025072000",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD NE",
            "identifier": "36335",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMARA",
            "last_name": "BONNES",
            "middle_name": "LYNN",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Grand Island, NE

Sources for this page

Verify at the official NPI Registry.