NPIMap

Individual provider Active NPI

Domenic C Izzo Jr., M.D.

  • Ophthalmology Physician
  • Wyomissing, PA
National Provider Identifier
1225028624
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD029312E Issued in PA
Practice address
1802 Papermill Rd
Wyomissing, PA 19610-1100
Phone
(610) 372-0712
Fax
(610) 376-6968
NPI assigned
Oct 26, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD029312E PA Primary

Addresses

Primary practice location

1802 Papermill Rd
Wyomissing, PA 19610-1100

Mailing address

1802 Papermill Rd
Wyomissing, PA 19610-1100
Phone (610) 372-0712

Other identifiers 6

IdentifierTypeStateIssuer
0011323630001MedicaidPA
1800009426OtherPARAILROAD MEDICARE
4338999OtherPAAETNA
01854302OtherPACAPITAL BLUE CROSS
473979OtherPAHIGHMARK BLUE SHIELD
0019746000OtherPAKEYSTONE HEALTH EAST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Hahnemann University College of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1802 Papermill Rd
Wyomissing, PA 19610-1100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.97 of 100Reported as individual
Quality
95.93
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery313

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD029312EPAMDOphthalmology Physician

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225028624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 PAPERMILL RD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101100",
            "telephone_number": "610-372-0712",
            "fax_number": "610-376-6968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 PAPERMILL RD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101100",
            "telephone_number": "610-372-0712",
            "fax_number": "610-376-6968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZZO",
        "first_name": "DOMENIC",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD029312E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011323630001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "1800009426",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4338999",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "01854302",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "473979",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH EAST",
            "identifier": "0019746000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

Verify at the official NPI Registry.