DR. DEREK JOHN BONACCI (O.D.) – Optometrist, NPI 1356572804
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
879 OPTOMETRY in MN
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Provider Addresses for DR. DEREK JOHN BONACCI (O.D.)
15th Street North, St. Cloud, Stearns County, Minnesota, 56303, United States
SAINT CLOUD, MN 563031747
Phone: (320) 251-1432
Fax: (320) 251-7122
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2009-10-08
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20091008000395 | I | Optometry | MN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 92014 | Established patient complete exam of visual system | 319 | 319 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 143 | 106 | $0 |
| 92250 | Photography of the retina | 79 | 78 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 65 | 59 | $0 |
| 92134 | Imaging of retina | 63 | 59 | $0 |
Insurance plans in this area (ZIP 56303)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| OPTOMETRY | MN | 92012 | Eye and medical examination for diagnosis and treatment, established patient | 14 | 14 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| O P H T H A L M O L O G Y | MN | |
| O P H T H A L M O L O G Y | MN | |
| O P T O M E T R Y | MN | |
| O P H T H A L M O L O G Y | MN |
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