Jacob Delis, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

18004342A Issued in IN

Practice address

3301 Lake Ave
Fort Wayne, IN 46805-5529

Phone

(260) 422-3937

NPI assigned

Jun 2, 2022

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

Medicare fee-for-service enrollment

Enrolled in IN

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

Indiana University - School of Optometry, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Ophthalmology P CGroup PAC ID 4688611692, 10 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.97 of 100Reported as group

Quality

89.8

Improvement activities

40

Cost

76.84

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jdelis@vco.intellechartdirect.net

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.

• Northeast Ophthalmology P C

  • Ophthalmology Physician
  • Fort Wayne, IN
  • NPI 1265418719
  Medicare reassignment Care Compare group NPD
• Northeast Ophthalmology P C

  • Durable Medical Equipment & Medical Supplies
  • Fort Wayne, IN
  • NPI 1235846650

  Optometrist

  NPD

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

{
    "created_epoch": "1654128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1780323238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055529",
            "telephone_number": "260-422-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055529",
            "telephone_number": "260-422-3937"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15707 Lima Rd",
            "address_purpose": "LOCATION",
            "city": "Huntertown",
            "state": "IN",
            "postal_code": "467489370",
            "country_code": "US",
            "telephone_number": "260-422-3937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7750 W Jefferson Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468044174",
            "country_code": "US",
            "telephone_number": "260-459-9595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELIS",
        "first_name": "JACOB",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-02",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004342A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Delatorre, RBT
• Delbello, LLC
• Mark William Delbello, M.D.
• Ashly Mariana Deleon, MAT, LAT, ATC
• Gabriel Deleon, RBT
• Megan Michelle Delis, OD
• Aron E Dellinger, D.D.S., M.S.D.
• Eric Lee Dellinger, D.D.S., M.S.D.
• Dominica Faith Dello Iocona, MSED, LMHCA
• Courtney Gale Deloney, PHD

• Optometrist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; 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.