Individual provider Active NPI

Jeannie Maureen Dehne, OPTOMETRIST

  • Optometrist
  • Sioux Falls, SD
National Provider Identifier
1124228267
Registry record updated Jan 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
640 Issued in SD
Practice address
5116 S Western Ave
Sioux Falls, SD 57108-2677
Phone
(605) 338-7104
NPI assigned
Jul 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 640 SD Primary

Addresses

Primary practice location

5116 S Western Ave
Sioux Falls, SD 57108-2677

Mailing address

5116 S Western Ave
Sioux Falls, SD 57108-2677
Phone (605) 338-7104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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

Enrollment IDStateProvider typePAC IDDetails
I20091216000026 SD Practitioner - Optometry 4587731047 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Eye Doctors PCGroup PAC ID 4688663370, 3 clinicians

Practice addresses (Care Compare)

5116 S Western Ave
Sioux Falls, SD 57108-2677
Phone (605) 338-7104

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery30

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
640SDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
The Eye Doctors PC Optometrist CurrentSince Sep 1, 2015 Accepting new patients
Outpost Optical Inc Optometrist Past Accepting new patients

Locations

5116 S Western Ave
Sioux Falls, SD 57108
Phone (605) 338-7104

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453766400000",
    "number": "1124228267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5116 S WESTERN AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571082677",
            "telephone_number": "605-338-7104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5116 S WESTERN AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571082677",
            "telephone_number": "605-338-7104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHNE",
        "first_name": "JEANNIE",
        "middle_name": "MAUREEN",
        "name_prefix": "Dr.",
        "credential": "OPTOMETRIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-18",
        "last_updated": "2016-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SD",
            "license": "640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.