Jacoby John Dewald, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2647 Issued in OK

Practice address

1418 Main St
Woodward, OK 73801-3004

Phone

(580) 256-6699

Fax

(580) 256-6706

NPI assigned

Jun 22, 2010

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 1

Medicare fee-for-service enrollment

Enrolled in OK

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, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Integris Health Woodward Hospital Hospital, Woodward, OK, CCN 370002

Merit-based Incentive Payment System (MIPS)

Final score

92.78 of 100Reported as individual

Quality

85.55

Improvement activities

40

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.

• Great Plains Vision Center

  • Optometrist
  • Woodward, OK
  • NPI 1194017020
  Medicare reassignment NPD Authorized official
• Frederick Eye Care PLLC

  • Optometrist
  • Frederick, OK
  • NPI 1164585758
  NPD (past)
• Frederick Eye Care PLLC

  • Optometrist
  • Woodward, OK
  • NPI 1265760680
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Integris Health Woodward Hospital Inc

  • General Acute Care Hospital
  • Woodward, OK
  • NPI 1558148627
  Care Compare affiliation

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

{
    "created_epoch": "1277164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348185600000",
    "number": "1740591973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2484",
            "city": "WOODWARD",
            "state": "OK",
            "postal_code": "738022484",
            "telephone_number": "580-256-6699",
            "fax_number": "580-256-6706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 MAIN ST",
            "city": "WOODWARD",
            "state": "OK",
            "postal_code": "738013004",
            "telephone_number": "580-256-6699",
            "fax_number": "580-256-6706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWALD",
        "first_name": "JACOBY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-22",
        "last_updated": "2012-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200298970A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lela Cupp, APRN, CNM
• Jenita Cutsinger, BHRS
• Delaini De la Cerda, BACHELORS
• Mary Degand
• Caleb Jordan Deviney
• Denise Dixon
• Sara Nicole Drinnon
• DRS Peck & Peck PC
• DRS Ray PLLC
• Dusty Nielsen, D.C. P.L.L.C.

• Optometrist in Woodward, OK
• Providers in Woodward, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.