Individual provider Active NPI

Dallin Joseph Andersen, MD

  • Ophthalmology Physician
  • Spokane, WA
National Provider Identifier
1225492333
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
61244190 Issued in WA
Practice address
427 S Bernard St
Spokane, WA 99204-2509
Phone
(509) 456-0107
Fax
(509) 747-2635
NPI assigned
Apr 6, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Retina Specialist (Ophthalmology) Physician 207WX0107X 61244190 WA
Ophthalmology Physician 207W00000X 61244190 WA Primary

Addresses

Primary practice location

427 S Bernard St
Spokane, WA 99204-2509

Mailing address

427 S Bernard St
Spokane, WA 99204-2509
Phone (509) 456-0107

Other practice location 1

31 E Central Ave
Spokane, WA 99208-1161
Phone (509) 456-0107

Other practice location 2

16201 E Indiana Ave Ste 5000
Spokane Valley, WA 99216-1883
Phone (509) 456-0107

Other identifiers 1

IdentifierTypeStateIssuer
2203889MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220715001786 WA Practitioner - Ophthalmology 8123309382 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Washington School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spokane Eye Clinic PSGroup PAC ID 1759278393, 36 clinicians

Practice addresses (Care Compare)

427 S Bernard St
Spokane, WA 99204-2509
Phone (509) 456-0107

Merit-based Incentive Payment System (MIPS)

Final score
90.64 of 100Reported as group
Quality
92.23
Promoting interoperability
100
Improvement activities
40
Cost
76.58

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61244190WAMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Retinal Consultants LLC Ophthalmology Current Accepting new patients
Spokane Eye Clinic PS Ophthalmology CurrentSince Aug 1, 2022 Accepting new patients
Spokane Eye Clinic PS Ophthalmology CurrentSince Aug 1, 2022 Accepting new patients

Locations

9651 N Nevada St
Spokane, WA 99218
Phone (509) 363-2180

427 S Bernard St
Spokane, WA 99204
Phone (509) 456-0107

31 E Central Ave
Spokane, WA 99208
Phone (509) 456-0107

16201 E Indiana Ave
Ste 5000
Spokane Valley, WA 99216
Phone (509) 456-0107

Interoperability endpoints

  • Direct secure messaging: dallin.andersen.p2@direct.spokaneeye.nextgenshare.com
  • Direct secure messaging: dandersen@arcnj.intellechartdirect.net

Organizations & group practices 3

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": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1225492333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 S BERNARD ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042509",
            "telephone_number": "509-456-0107",
            "fax_number": "509-747-2635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 S BERNARD ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042509",
            "telephone_number": "509-456-0107",
            "fax_number": "509-747-2635"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "31 E Central Ave",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992081161",
            "country_code": "US",
            "telephone_number": "509-456-0107",
            "fax_number": "509-747-2635",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16201 E Indiana Ave Ste 5000",
            "address_purpose": "LOCATION",
            "city": "Spokane Valley",
            "state": "WA",
            "postal_code": "992161883",
            "country_code": "US",
            "telephone_number": "509-456-0107",
            "fax_number": "509-747-2635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "DALLIN",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-06",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "WA",
            "license": "61244190",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WA",
            "license": "61244190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2203889",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.