Chad J Preiss, O.D.
Individual provider Active NPI Optometrist · Pinon, AZ
NPI 1245349448 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1245349448
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 2957035 (WI)
- Practice address
- Navajo Route 4
Pinon, AZ 86510 - Phone
- (928) 674-7001
- Fax
- (928) 674-7705
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230223002984 | AK | Practitioner - Optometry | 4486684537 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2957035 | WI | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Latitude 61 Eyecare, LLC | Optometrist | Current | Accepting new patients |
| S & P Optometry Incorporated | Optometrist | Current |
Accepting new patients |
| Quentin N Burdick Comprehensive Health Care Facility | Past | Accepting new patients | |
| Southcentral Foundation | Past | Accepting new patients | |
| Southcentral Foundation | Past | Accepting new patients |
Locations
44332 Sterling Hwy
#118
Soldotna, AK 99669
Phone (907) 260-9199
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2957035 | WI | Yes |
Addresses
Primary practice location
Navajo Route 4
Pinon, AZ 86510
Mailing address
PO Drawer PH
Chinle, AZ 86503
Phone (928) 674-7001
Other providers in Pinon, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.