Individual provider Active NPI

Dierdre A. Fogle, O.D.

  • Optometrist
  • Littleton, CO
National Provider Identifier
1245227024
Registry record updated Sep 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1961 Issued in CO
Practice address
8089 S Lincoln St Ste 103
Littleton, CO 80122-2719
Phone
(303) 471-2015
Fax
(303) 471-2042
NPI assigned
Oct 5, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 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 1961 CO Primary

Addresses

Primary practice location

8089 S Lincoln St Ste 103
Littleton, CO 80122-2719

Mailing address

8089 S Lincoln St
Suite 103
Littleton, CO 80122-2700
Phone (303) 471-2015

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050112000419 CO Practitioner - Optometry 1052369410 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peek Eyecare LLCGroup PAC ID 5496290108, 2 clinicians

Practice addresses (Care Compare)

8089 S Lincoln St
Suite 103
Littleton, CO 80122-2719
Phone (303) 471-2015

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1961COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Peek Eyecare LLC Optometrist CurrentSince Mar 21, 2024 Accepting new patients
Northglenn Optometric Center, P.C. Optometrist Past Accepting new patients

Locations

8089 S Lincoln St
Ste 103
Littleton, CO 80122
Phone (303) 471-2015

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": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1245227024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8089 S LINCOLN ST",
            "address_2": "SUITE 103",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801222700",
            "telephone_number": "303-471-2015",
            "fax_number": "303-471-2042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8089 S LINCOLN ST STE 103",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801222719",
            "telephone_number": "303-471-2015",
            "fax_number": "303-471-2042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGLE",
        "first_name": "DIERDRE",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-05",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "1961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Littleton, CO

Sources for this page

Verify at the official NPI Registry.