Sander Sol Dorfzaun, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT000754 Issued in GA

Practice address

850 Old Piedmont Rd
Marietta, GA 30066-5490

Phone

(770) 422-3677

Fax

(770) 422-5814

NPI assigned

Mar 2, 2007

Sex

Male

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 GA

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

Other, 1973

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Old Piedmont Eye Group LLCGroup PAC ID 1052831237, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

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.

• Dorfzaun Eye Group,L.L.C.

  • Optometrist
  • Marietta, GA
  • NPI 1871922385
  Medicare reassignment NPD Authorized official
• Old Piedmont Eye Group LLC

  • Optometrist
  • Marietta, GA
  • NPI 1477379709
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1699804120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 OLD PIEDMONT RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300665490",
            "telephone_number": "770-422-3677",
            "fax_number": "770-422-5814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 OLD PIEDMONT RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300665490",
            "telephone_number": "770-422-3677",
            "fax_number": "770-422-5814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORFZAUN",
        "first_name": "SANDER",
        "middle_name": "SOL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT000754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DURABLE GOODS",
            "identifier": "0866240001",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00082607A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "580000223",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Donohue, OTR/L
• Mary Wolfe Doornbos, DMD
• Kevin James Doran, DDS
• Barbara Sainte Dorcely, REGISTERED NURSE
• Dorfzaun Eye Group,L.L.C.
• John Marvin Doris, D.D.S.
• Gwendolyn Barron Dorman, MSPT
• Samin Dorri, DMD
• Jayli Dorsey
• Kathleen M Dorsey

• Optometrist in Marietta, GA
• Providers in Marietta, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; 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.