Gretchen D Ariz, O.D.

Individual provider Active NPI Optometrist · Jber, AK

NPI 1295874907 · NPPES record last updated Jun 20, 2014

Key facts

NPI
1295874907
Entity type
Individual (NPI type 1)
Primary specialty
Optometrist 152W00000X
License
344 (AK)
Practice address
5955 Zeamer Ave
673D MDG
Jber, AK 99506-3702
Phone
(907) 580-1150
Fax
(907) 580-1152
NPI assigned
Feb 6, 2007
Sex
Female
Sole proprietor
Yes

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 IDStateProvider typePAC IDDetails
I20140815002201 AK Order and Referring Only - Optometry
Practitioner - Optometry
2163649005

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
344AKMDOptometrist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 344 AK Yes

Addresses

Primary practice location

5955 Zeamer Ave
673D MDG
Jber, AK 99506-3702

Mailing address

5955 Zeamer Ave
673D MDG
Jber, AK 99506-3702
Phone (907) 580-1150

Other providers in Jber, AK

All providers in Jber, AK · Optometrist in Alaska

Sources for this page

Verify at the official NPI Registry.