Jeffery L. Dibenedetto, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1321-456T Issued in LA

Practice address

2290 S Range Ave
Denham Springs, LA 70726-5214

Phone

(225) 665-2019

Fax

(225) 665-2089

NPI assigned

Jun 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

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

Southern College of Optometry, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Care and Cosmetic Center, LLCGroup PAC ID 9931201738, 4 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.

• Eye Care & Cosmetic Center, LLC

  • Ophthalmology Physician
  • Zachary, LA
  • NPI 1639258726
  Medicare reassignment Care Compare group NPD
• Williamson Eye Center

  • Ophthalmology Physician
  • Gonzales, LA
  • NPI 1699812909

  Optometrist

  Medicare reassignment NPD
• Eye Care and Cosmetic Center, LLC

  • Optometrist
  • Zachary, LA
  • NPI 1346368412
  NPD
• Williamson Eye Center

  • Ophthalmology Physician
  • Saint Francisville, LA
  • NPI 1487495131

  Optometrist

  NPD
• Allemond and Jelks LLC

  • Optometrist
  • Port Allen, LA
  • NPI 1295369817
  NPD (past)
• Gitter and Cohen a Medical Corporation

  • Retina Specialist (Ophthalmology) Physician
  • Metairie, LA
  • NPI 1740379783
  NPD (past)
• The Hammond Eye Clinic, L.L.C.

  • Optometrist
  • Hammond, LA
  • NPI 1386715985
  NPD (past)

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327622400000",
    "number": "1255360525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2290 S RANGE AVE",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707265214",
            "telephone_number": "225-665-2019",
            "fax_number": "225-665-2089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2290 S RANGE AVE",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707265214",
            "telephone_number": "225-665-2019",
            "fax_number": "225-665-2089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBENEDETTO",
        "first_name": "JEFFERY",
        "middle_name": "L.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2012-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1321-456T",
            "primary": true
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "LA",
            "license": "1321-456T",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "LA",
            "license": "1321-456T",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1105350",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carly McCoy Denton
• Department of Health & Hospital
• Erin Devall
• Kaylie Devall, FNP
• Taylor Briann Deville
• Celeste Baker Dicarlo, OD
• Reshonda Dickerson
• Scott Dickie, PT, LMT, COMT
• Dickinson Chiropractic LLC
• Peter Don Dickinson, D.C.

• Optometrist in Denham Springs, LA
• Providers in Denham Springs, LA by specialty
• Optometrist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2012; 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.