BONNER GENERAL HOSPITAL, INC
NPI 1104461649
Ophthalmology in Sandpoint, ID
About Bonner General Hospital, Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BONNER GENERAL HOSPITAL, INC (NPI 1104461649), doing business as Bonner General Ophthalmology, is a healthcare organization registered as an ophthalmology in Sandpoint, Idaho and active in the NPI registry since November 2019. The organization holds a CLIA Waiver certificate valid through July 6, 2028 and lists John Hennessy, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Bonner General Hospital, Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by November 30, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
74Medicare enrollment records show 74 clinicians reassign Medicare billing to Bonner General Hospital, Inc, which bills Medicare for the services they deliver. Of these, 7 practice at this address and 25 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 14
Nearest to this location (20)
See all 74Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 13D2346758
Bonner General Urology · Sandpoint, IDFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Bonner General Hospital, Inc's NPI number?
The NPI number for Bonner General Hospital, Inc is 1104461649. It was assigned to this organization in the NPPES registry on November 7, 2019. The provider is doing business as Bonner General Ophthalmology.
Where is Bonner General Hospital, Inc located?
Bonner General Hospital, Inc is located at 423 N 3rd Ave Ste 110, Sandpoint, ID 83864. The listed phone number is (208) 265-1011.
What is Bonner General Hospital, Inc's specialty?
The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.
Is Bonner General Hospital, Inc enrolled in Medicare?
Yes. Bonner General Hospital, Inc is registered in the Medicare PECOS enrollment system.
When is Bonner General Hospital, Inc's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Idaho, Clinic/Group Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Bonner General Hospital, Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 74 clinicians in 14 Medicare specialties reassign their Medicare billing to Bonner General Hospital, Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Diagnostic Radiology (29), Nurse Practitioner (14) and Emergency Medicine (11). Of these, 7 practice at this address and 25 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Bonner General Hospital, Inc hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 13D2346758) is associated with this NPI, valid through July 6, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Bonner General Hospital, Inc accept?
Health plans from Molina Healthcare list Bonner General Hospital, Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Bonner General Hospital, Inc was last updated on September 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 43 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Bonner General Hospital, Inc · NPI 1104461649
Ophthalmology organization in Sandpoint, Idaho. Organization record, active in the CMS NPPES registry since November 7, 2019.
## Identity
- **NPI:** 1104461649 (Entity type: Organization)
- **Enumerated:** November 7, 2019
- **Primary specialty:** Ophthalmology · taxonomy 207W00000X
- **Also known as:** Bonner General Ophthalmology (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** John Hennessy, CEO
## Practice location
- **Address:** 423 N 3RD AVE STE 110, Sandpoint, ID 83864-1511
- **Phone:** (208) 265-1011 · **Fax:** (208) 265-6271
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** November 30, 2026 (Non-DME Part B, Idaho, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 74 clinicians in 14 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Diagnostic Radiology (29), Nurse Practitioner (14), Emergency Medicine (11); 7 practice at this address and 25 within 10 miles; [full list](https://npiprofile.com/npi/1104461649/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 25, 2026
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1104461649) · Data from the CMS NPPES public registry.