Bonnie Lynn Nickel, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

00G362480 Issued in CA

Practice address

750 Las Gallinas Ave
Suite 114
San Rafael, CA 94903-3438

Phone

(415) 492-0950

Fax

(415) 492-9029

NPI assigned

Nov 8, 2007

Sex

Female

Sole proprietor

Yes

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 CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Un of California, Irvine, College of Medicine, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Bonnie Nickel, M.D,

  • Ophthalmology Physician
  • San Rafael, CA
  • NPI 1649349283
  NPD (past) Authorized official
• Marin General Hospital

  • General Acute Care Hospital
  • Greenbrae, CA
  • NPI 1396725677
  NPD (past)

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194480000000",
    "number": "1881874709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 LAS GALLINAS AVENUE",
            "address_2": "SUITE 114",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033431",
            "telephone_number": "415-492-0950",
            "fax_number": "415-492-9029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 LAS GALLINAS AVE",
            "address_2": "SUITE 114",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033438",
            "telephone_number": "415-492-0950",
            "fax_number": "415-492-9029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKEL",
        "first_name": "BONNIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-08",
        "last_updated": "2007-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "00G362480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yasmin K Nibbe, MD
• Grace Niccum, CCC-SLP
• Lelah Joy Nichol, L.C.S.W
• Christopher Burl Nichols, RADT
• Amy Nickel
• Monica Nicol
• Patricia A Nicol, M.D.
• Gary S. Nicolaisen, MD
• Claire Nilsen, CCMA
• Jaime Nisenbaum, PH.D.

• Ophthalmology Physician in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; 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.