Individual provider Active NPI

John Thomas Dellacroce, MD

  • Retina Specialist (Ophthalmology) Physician
  • Fayetteville, AR
National Provider Identifier
1780619718
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
E-7012 Issued in AR
Practice address
1794 E Joyce Blvd Ste 3
Fayetteville, AR 72703-5257
Phone
(479) 234-4499
Fax
(479) 269-1325
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Retina Specialist (Ophthalmology) Physician 207WX0107X E-7012 AR Primary

Addresses

Primary practice location

1794 E Joyce Blvd Ste 3
Fayetteville, AR 72703-5257

Mailing address

1794 E Joyce Blvd Ste 3
Fayetteville, AR 72703-5257
Phone (479) 234-4499

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110628000209 AR Practitioner - Ophthalmology 2668473463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Louisiana State University School of Medicine in Shreveport, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Retina Center of Arkansas PLLCGroup PAC ID 1759784143, 3 clinicians

Practice addresses (Care Compare)

1794 E Joyce Blvd
Suite 3
Fayetteville, AR 72703-5257
Phone (479) 234-4499

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.29 of 100Reported as group
Quality
100
Improvement activities
40
Cost
94.3

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-7012ARMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Retina Center of Arkansas PLLC Retina Specialist CurrentSince Jun 1, 2021 Accepting new patients
The Administrators of the Tulane Educational Fund Past Accepting new patients
Caplan Eye Clinic a Professional Medical Corporation Past Accepting new patients
Administrators of the Tulane Educational Fund Past Accepting new patients

Locations

1794 E Joyce Blvd
Ste 3
Fayetteville, AR 72703
Phone (479) 234-4499

5501 Willow Creek Dr
Ste 203B
Springdale, AR 72762
Phone (479) 419-9393

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1780619718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1794 E JOYCE BLVD STE 3",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035257",
            "telephone_number": "479-234-4499",
            "fax_number": "479-269-1325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1794 E JOYCE BLVD STE 3",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035257",
            "telephone_number": "479-234-4499",
            "fax_number": "479-269-1325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELLACROCE",
        "first_name": "JOHN",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "AR",
            "license": "E-7012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.