Benjamin David Dietrich, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004764 Issued in MI

Practice address

300 N State St
Harrisville, MI 48740-9693

Phone

(989) 724-7440

Fax

(989) 724-7531

NPI assigned

Jun 20, 2013

Last updated

Jul 14, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Dietrich PC

  dba Harrisville Eye Care

  • Optometrist
  • Harrisville, MI
  • NPI 1497173322
  Medicare reassignment NPD
• Pasqua Darnell PC

  dba Harrisville Eye Care

  • Optometrist
  • Harrisville, MI
  • NPI 1033106406
  NPD
• Advanced Pain Relief Centers Inc

  • Interventional Pain Medicine Physician
  • Martinsburg, WV
  • NPI 1376885095
  NPD
• Eye Talk Inc.

  • Eyewear Supplier
  • Alpena, MI
  • NPI 1184084642
  NPD (past)

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

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1073952297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N STATE ST",
            "city": "HARRISVILLE",
            "state": "MI",
            "postal_code": "487409693",
            "telephone_number": "989-724-7440",
            "fax_number": "989-724-7531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N STATE ST",
            "city": "HARRISVILLE",
            "state": "MI",
            "postal_code": "487409693",
            "telephone_number": "989-724-7440",
            "fax_number": "989-724-7531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETRICH",
        "first_name": "BENJAMIN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-20",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD PIN",
            "identifier": "0Z10008",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catholic Human Services Inc
• Carey Lynn Check, D.O.
• County of Alcona
• Kristin M Denig, PA
• Dietrich PC (Harrisville Eye Care)
• Tami Loree Dipzinski, MA
• Kathleen June Dunckel, M.D.
• Andrea Kristen Eby, FNP-BC
• Katelyn Effrick
• Kathryn Fouchey, LPC

• Optometrist in Harrisville, MI
• Providers in Harrisville, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2023; 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.