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Deactivated NPI 1194724328 Deactivated / Inactive NPI Male Practitioner

Dr. John S Bonebrake , OD

Optometrist • Saint Joseph, MO

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. John Bonebrake has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 19, 2005
NPI Deactivation Date March 20, 2006
Total Practice Duration ~1 Years of Practice (2005 – 2006)

Professional Overview & Biography Verified Profile Summary

Dr. John Bonebrake, OD was a registered Optometrist practicing in Saint Joseph, MO. Throughout an active medical career spanning 1 years, Dr. Bonebrake provided care at the practice location at 707 N 36TH ST until profile deactivation on 2006-03-20.

Historical Medicare Part B clinical services included established patient complete exam of visual system, imaging of retina, imaging of optic nerve. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

707 N 36th St
Suite A

Saint Joseph, MO 645062968

Telephone 8162795683
Fax 8162795685
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Saint Joseph, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 16.7 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
21 Specialists

Practicing in Saint Joseph, MO (1288 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
36.5% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2018)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
92014 Established patient complete exam of visual system
122 120 $151.00 $113.06
92134 Imaging of retina
46 43 $83.00 $37.21
92133 Imaging of optic nerve
14 14 $83.00 $33.75
92004 New patient complete exam of visual system
12 12 $187.00 $136.10

Medical Specialties & State Licenses

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License MO T02478

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
311944706 (MO)
Commercial Insurance / Payer ID Rr Medicare
410048243
Commercial Insurance / Payer ID Bc Bs
108900
Commercial Insurance / Payer ID Cds
200111698 (MO)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1477360865

Doctor of Chiropractic

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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Updated Practice Location November 25, 2008

Registered at 707 N 36TH ST, SUITE A, SAINT JOSEPH, MO 645062968 (Tel: 8162795683)

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Updated Business Mailing Address November 25, 2008

Registered at 707 N 36TH ST, SUITE A, SAINT JOSEPH, MO 645062968 (Tel: 8162795683)

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Provider Name / Credentials Updated November 25, 2008

Recorded as JOHN BONEBRAKE, O.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) November 25, 2008

Optometrist (License #T02478 in MO)

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NPI Profile Reactivated March 27, 2006

Record officially reactivated for active practice on March 27, 2006

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NPI Profile Deactivated March 20, 2006

Record deactivated on March 20, 2006

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Initial NPI Registration & Enumeration July 19, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1194724328
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 19, 2005
Last Update: March 07, 2023
Deactivation Date: March 20, 2006
Sole Proprietor: Yes

Mailing Address

707 N 36th St, Suite A

Saint Joseph, MO 645062968

Phone: 8162795683

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.