Jennifer Denhartog, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

02164 Issued in IA

Practice address

12695 University Ave Ste 170
Clive, IA 50325-8217

Phone

(515) 512-1444

Fax

(515) 512-1440

NPI assigned

May 4, 2006

Reactivated

Sep 17, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IA

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

Indiana University - School of Optometry, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jennifer Denhartog OD LLCGroup PAC ID 9133419302, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Jennifer Denhartog OD LLC

  • Optometrist
  • Clive, IA
  • NPI 1649634478

  IA, Optometrist

  Medicare reassignment Care Compare group NPD Authorized official
• Associated Ophthalmologists, PC

  • Optometrist
  • Des Moines, IA
  • NPI 1588622278
  NPD (past)

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538524800000",
    "number": "1285682245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4702 148TH ST",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503232074",
            "telephone_number": "515-210-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12695 UNIVERSITY AVE STE 170",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258217",
            "telephone_number": "515-512-1444",
            "fax_number": "515-512-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENHARTOG",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2018-10-03",
        "deactivation_date": "2018-09-11",
        "reactivation_date": "2018-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "02164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS INDIVIDUAL NUMBER",
            "identifier": "24569",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0229344",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0893990001",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Anne Dauterive, BCBA
• Anjanette Davis, RPH
• Steven C Dawdy, PH.D.
• Debra Dean, ARNP
• Mirsada Dedic, ARNP
• Christine Nicole Dennison, OTR/L, OTD
• Dermatology and Dermatologic Surgery Center, PC
• Emily Ann Dermody, ARNP
• Des Moines OB GYN Specialists PC
• Andrea G Dettmann-Spurgeon, CPNP, ARNP

• All providers in Clive, IA
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; 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.