Grace Lea Yu Dumayas-Booth, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG 001649 Issued in PA

Practice address

Landstuhl Regional Medical Center
Wiesbaden Health Clinic Unit 29623
Apo, AE 09096
DE

Phone

011496117057307

Fax

011496117055984

NPI assigned

May 5, 2006

Last updated

Jun 18, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Grace Lea Dewars Former name

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pennsylvania College of Optometry, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aeg South Carolina Professional PCGroup PAC ID 5597129064, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Aeg South Carolina Professional PC

  • Optometrist
  • Columbia, SC
  • NPI 1720768427
  Medicare reassignment Care Compare group NPD
• Benjamin J Bittner OD Inc

  • Optometrist
  • Myrtle Beach, SC
  • NPI 1396142899
  Medicare reassignment NPD
• Carolina Forest Family Eyecare, P.a.

  • Optometrist
  • Myrtle Beach, SC
  • NPI 1972621423
  NPD (past)

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1013965409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4430 MISSOURI AVE # 1263",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654739098",
            "telephone_number": "573-596-0048"
        },
        {
            "country_code": "DE",
            "country_name": "Germany",
            "address_purpose": "LOCATION",
            "address_type": "FGN",
            "address_1": "LANDSTUHL REGIONAL MEDICAL CENTER",
            "address_2": "WIESBADEN HEALTH CLINIC UNIT 29623",
            "city": "APO",
            "state": "AE",
            "postal_code": "09096",
            "telephone_number": "011496117057307",
            "fax_number": "011496117055984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUMAYAS-BOOTH",
        "first_name": "GRACE LEA",
        "middle_name": "YU",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002700",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG 001649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRACE",
            "last_name": "DEWARS",
            "middle_name": "LEA",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; 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.