Willie Benton Boone, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

G13745 Issued in CA

Practice address

25 Tramonto Dr
Rancho Palos Verdes, CA 90275-5387

Phone

(310) 265-9313

Fax

(310) 265-8434

NPI assigned

Jun 24, 2006

Last updated

May 17, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Dr. W. Benton Boone Professional name

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

Meharry Medical College School of Medicine, 1966

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

W Benton Boone MD MsGroup PAC ID 1052894904, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• W Benton Boone MD Ms

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Torrance, CA
  • NPI 1588530976
  Medicare reassignment Care Compare group NPD
• Paradigm Vision Care Medical Associates

  • Specialist
  • Los Angeles, CA
  • NPI 1780606673
  NPD (past) Authorized official
• Paradigm Vision Care Medical Associates

  • Specialist
  • Inglewood, CA
  • NPI 1891892071
  NPD (past) Authorized official
• W. Benton Boone a Professional Corporation

  • Specialist
  • Los Angeles, CA
  • NPI 1730114257
  NPD (past) Authorized official

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368748800000",
    "number": "1942236542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 TRAMONTO DR",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902755387",
            "telephone_number": "310-265-9313",
            "fax_number": "310-265-8434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 TRAMONTO DR",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902755387",
            "telephone_number": "310-265-9313",
            "fax_number": "310-265-8434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOONE",
        "first_name": "WILLIE",
        "middle_name": "BENTON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2013-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G13745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA LICENSE",
            "identifier": "G13745",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PROVIDER TRANSACTION ACCESS NUMBER (PTAN)",
            "identifier": "WG13745C",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G137450",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "W.",
            "last_name": "BOONE",
            "middle_name": "BENTON",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Nelly Bertolina, LCSW
• Mark Bertrand, DPT
• Bita Rejai, Rd, a Professional Corporation
• Kathleen Mary Blenko
• Michael R Booher
• Bernard Morton Borgida, M.D.
• Alyssa Borrilez, IBCLC
• Ann Marie Boss, CNM
• Heather Bowman, OD
• Wesley G. Bradford, MD

• Ophthalmology Physician in Rancho Palos Verdes, CA
• Providers in Rancho Palos Verdes, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2013; 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.