Brett Alan Dietz, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

5109 Issued in OH

Practice address

114 N Galway Dr
Granville, OH 43023-9572

Phone

(740) 587-4970

Fax

(740) 587-4863

NPI assigned

Sep 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH

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

Ohio State University - College of Optometry, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nancy R Dietz, O.D.

  • Optometrist
  • Granville, OH
  • NPI 1205926318
  Medicare reassignment

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 Site, L.L.C.

  • Optometrist
  • Millersport, OH
  • NPI 1780806067
  NPD (past) Authorized official

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

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355356800000",
    "number": "1356441802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 N GALWAY DR",
            "city": "GRANVILLE",
            "state": "OH",
            "postal_code": "430239572",
            "telephone_number": "740-587-4970",
            "fax_number": "740-587-4863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 N GALWAY DR",
            "city": "GRANVILLE",
            "state": "OH",
            "postal_code": "430239572",
            "telephone_number": "740-587-4970",
            "fax_number": "740-587-4863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETZ",
        "first_name": "BRETT",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-24",
        "last_updated": "2012-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2235414",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD BOARD",
            "identifier": "410046458",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tung Van Dao, DPM, MS
• Elijah Xiaosen Davis
• Alyssa Debord, MS, RD
• Donald Albert Deshetler Jr., MD
• Debbie Elaine Dickson, LISW
• Nancy R Dietz, O.D.
• Richard John Dirks
• Disability Employment Services
• Megan Donelan, LPC
• Lauren Merissa Doran, CFNC

• Optometrist in Granville, OH
• Providers in Granville, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.