Derek James Dake, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901005127 Issued in MI

Practice address

504 W Harrie St
Newberry, MI 49868-1200

Phone

(906) 291-2015

NPI assigned

Jul 12, 2018

Sex

Male

Sole proprietor

Yes

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.

• Derek J Dake OD PC

  • Optometrist
  • Newberry, MI
  • NPI 1770319352

  MI, Optometrist

  Medicare reassignment NPD Authorized official
• Dale W Muth OD PLLC

  • Optometrist
  • Newberry, MI
  • NPI 1255463162

  MI, Optometrist

  Medicare reassignment NPD

Specialty

Optometry

Education

Ferris State College - College of Optometry, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: derek.dake@direct.revolutionehr.com

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 12, 2018.

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531353600000",
    "number": "1740766716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 W VICTORY WAY",
            "city": "NEWBERRY",
            "state": "MI",
            "postal_code": "498681647",
            "telephone_number": "906-322-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 W HARRIE ST",
            "city": "NEWBERRY",
            "state": "MI",
            "postal_code": "498681200",
            "telephone_number": "906-291-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAKE",
        "first_name": "DEREK",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-12",
        "last_updated": "2018-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chippewa Dialysis Services
• County of Luce
• Quin Curley
• Michelle Zang Curtis-Nutkins, LLP
• Brook Lynn Dake, FNP-C
• Dale W Muth OD PLLC
• Dale W Muth OD PLLC
• Denise Magdalene Danaher, WHNP
• Christine Elizabeth Deangelo, PA
• Derek J Dake OD PC

• All providers in Newberry, MI
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; 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.