Justin Daniel Deal, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2875 Issued in CO

Practice address

1200 S Hover St
Longmont, CO 80501-7902

Phone

(303) 845-4215

Fax

(303) 682-8181

NPI assigned

Sep 6, 2011

Sex

Male

Sole proprietor

Yes

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 CO

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

Illinois College of Optometry at Chicago, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optometric Associates PCGroup PAC ID 0345131033, 6 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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 and National Provider Directory roles.

• Optometric Associates PC

  • Optometrist
  • Longmont, CO
  • NPI 1730299116
  Medicare reassignment Care Compare group NPD
• Boulder Eye Care Professionals LLC

  • Optometrist
  • Boulder, CO
  • NPI 1689918799
  NPD (past)

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

{
    "created_epoch": "1315267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474934400000",
    "number": "1134400054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S HOVER ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805017902",
            "telephone_number": "303-845-4215",
            "fax_number": "303-682-8181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S HOVER ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805017902",
            "telephone_number": "303-845-4215",
            "fax_number": "303-682-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAL",
        "first_name": "JUSTIN",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-06",
        "last_updated": "2016-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54686270",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John C Daw, O.D.
• Jimmy De Herrera, C.A.S. II
• Diva De Leon Coffin, BCBA
• Paula De Oliveira Santos, MA
• Sophia R De St Simon
• Amanda Dean, MA CCC SLP
• Amanda Dean, CLC
• Lauren Dean
• Debbie Mayer, LCSW, LLC
• Todd Deboom, MD

• Optometrist in Longmont, CO
• Providers in Longmont, CO by specialty
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2016; 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.