Active NPI
Damien R Delzer, OD
- Optometrist
- Fairbanks, AK
National Provider Identifier
1346228517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT T 156
- Practice address
- 116 Minnie St
Fairbanks, AK 99701-3006 - Phone
- (907) 456-7760
- Fax
- (907) 451-7916
- NPI assigned
- Jan 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT T 156 | AK | Primary |
Addresses
Primary practice location
116 Minnie St
Fairbanks, AK 99701-3006
Mailing address
116 Minnie St
Fairbanks, AK 99701-3006
Phone (907) 456-7760
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A0330 | Other | AK | BLUE CROSS |
| OD0156 | Medicaid | AK | |
| 0194434 | Other | AK | DEPT OF LABOR GROUP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Ohio State University - College of Optometry, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
116 Minnie St
Fairbanks, AK 99701-3006
Phone (907) 456-7760
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 14.17 of 100
- Quality
- 28.35
- Improvement activities
- 0
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 156 | AK | MD | Chiropractor |
| OPT T 156 | AK | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eye Clinic of Fairbanks, Inc | Optometrist | Current | Accepting new patients |
Locations
116 Minnie St
Fairbanks, AK 99701
Phone (907) 456-7760
Organizations & group practices 1
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.
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fairbanks, AK
- NPI 1720537178
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480377600000",
"number": "1346228517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 MINNIE ST",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997013006",
"telephone_number": "907-456-7760",
"fax_number": "907-451-7916"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 MINNIE ST",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997013006",
"telephone_number": "907-456-7760",
"fax_number": "907-451-7916"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELZER",
"first_name": "DAMIEN",
"middle_name": "R",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-06",
"last_updated": "2016-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AK",
"license": "OPT T 156",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "A0330",
"state": "AK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "OD0156",
"state": "AK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF LABOR GROUP",
"identifier": "0194434",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fairbanks, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; 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.