BOHANNAN ANESTHESIA PLLC – Ophthalmologic Surgery Clinic/Center, NPI 1740758366
Ophthalmologic Surgery Clinic/Center
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for BOHANNAN ANESTHESIA PLLC
12688, Miller Church Road, Miller, Bentonville, Benton County, Arkansas, 72712, United States
BENTONVILLE, AR 727129041
Phone: (479) 530-6649
Type: Mailing
BoozmanHof Regional Eye Clinic, 3737, West Walnut Street, Rogers, Benton County, Arkansas, 72756, United States
ROGERS, AR 727561839
Phone: (479) 246-1751
Type: Location
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.
This can happen when there are no reportable CMS Open Payments records.
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: 2018-12-17
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-12-31 (898 days ago).
Enrollment records
1
Earliest due date
2023-12-31
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 |
|---|---|---|---|---|
| O20181217001743 | O | Clinic/Group Practice | AR | 2023-12-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 72712)
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