Justin Bohnsack, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3943 Issued in MN

Practice address

1 Central Ave W Ste 104
Saint Michael, MN 55376-4590

Phone

(375) 476-3497

NPI assigned

Jun 10, 2024

Last updated

Jun 10, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

University of Missouri St Louis - School of Optometry, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

D Stanton Enterprises LLCGroup PAC ID 6608964861, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• D. Stanton Enterprises, LLC

  dba EyeWest Vision Clinic & Optical

  • Optometrist
  • Rogers, MN
  • NPI 1063594109
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1821830019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CENTRAL AVE W STE 104",
            "city": "SAINT MICHAEL",
            "state": "MN",
            "postal_code": "553764590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CENTRAL AVE W STE 104",
            "city": "SAINT MICHAEL",
            "state": "MN",
            "postal_code": "553764590",
            "telephone_number": "375-476-3497"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13900 Northdale Blvd",
            "address_purpose": "LOCATION",
            "city": "Rogers",
            "state": "MN",
            "postal_code": "553749627",
            "country_code": "US",
            "telephone_number": "763-428-3757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOHNSACK",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Ruby Bernard
• Janet Bosibori Binyanya
• John Richard Biorn, DDS
• Starr Bonny-Jean Blazio
• Kelsey Ann Blommer
• Boone Family Chiropractic and Wellness, PLC
• Jazmin Brook Borst, LICSW
• David Brandt
• Amy Marie Breen
• Andrew Briggs, PHARMD

• Optometrist in Saint Michael, MN
• Providers in Saint Michael, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.