Courtney Kassebaum Bovy, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT 15011 TLG Issued in CA

Practice address

5655 E la Palma Ave Ste 150
Anaheim, CA 92807-2122

Phone

(714) 340-0520

NPI assigned

Nov 3, 2014

Last updated

Feb 13, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spectacle Optometry IncGroup PAC ID 1759619687, 2 clinicians

Practice addresses (Care Compare)

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.

• Spectacle Optometry, Inc.

  • Optometrist
  • Anaheim, CA
  • NPI 1134690811
  Medicare reassignment Care Compare group NPD Authorized official
• C & C Optometry, Inc.

  • Optometrist
  • Orange, CA
  • NPI 1730558784
  NPD

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

{
    "created_epoch": "1414972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1932504925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5655 E LA PALMA AVE STE 150",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928072122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5655 E LA PALMA AVE STE 150",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928072122",
            "telephone_number": "714-340-0520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOVY",
        "first_name": "COURTNEY",
        "middle_name": "KASSEBAUM",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-03",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 15011 TLG",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "OPT 15011 TLG",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "CA",
            "license": "OPT 15011 TLG",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "CA",
            "license": "OPT 15011 TLG",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "CA",
            "license": "OPT 15011 TLG",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawn Bridget Bourgon, PA
• Mokhtar Boushaba, D.M.D
• Angelique Bridgette Bouvier
• Luca Bova
• Stephanie Boverie
• Timothy Leon Bowen
• Sherri Liane Bower, PTA
• Abdelilleh Bowghanem, M.D
• Bowles Family Dental Corp
• Andrew Lee Bowman

• Optometrist in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; 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.