Individual provider Active NPI

David Justin Holdgrafer, O.D.

  • Optometrist
  • Soldotna, AK
National Provider Identifier
1124572805
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
113618 Issued in AK
Practice address
170 E Corral Ave Ste 1
Soldotna, AK 99669-7548
Phone
(907) 262-3168
Fax
(888) 220-2134
NPI assigned
Aug 10, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X 113618 AK Primary

Addresses

Primary practice location

170 E Corral Ave Ste 1
Soldotna, AK 99669-7548

Mailing address

170 E Corral Ave Ste 1
Soldotna, AK 99669-7548
Phone (907) 262-3168

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20160929001814 AK Practitioner - Optometry 5991092231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

170 E Corral Ave
Suite 1
Soldotna, AK 99669-7548
Phone (907) 262-3168

Merit-based Incentive Payment System (MIPS)

Final score
34.08 of 100Reported as individual
Quality
68.17
Improvement activities
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Soldotna Optometry Clinic, LLC Optometrist CurrentSince Apr 1, 2020 Accepting new patients
DH Optometric Solutions Inc Optometrist CurrentSince Apr 1, 2020 Accepting new patients

Locations

155 Smith Way
Ste 202
Soldotna, AK 99669
Phone (907) 262-3168

170 E Corral Ave
Ste 1
Soldotna, AK 99669
Phone (907) 262-3119

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": "1470787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1124572805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 E CORRAL AVE STE 1",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697548",
            "telephone_number": "907-262-3168",
            "fax_number": "888-220-2134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 E CORRAL AVE STE 1",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697548",
            "telephone_number": "907-262-3168",
            "fax_number": "888-220-2134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDGRAFER",
        "first_name": "DAVID",
        "middle_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-10",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AK",
            "license": "113618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Soldotna, AK

Sources for this page

Verify at the official NPI Registry.