Individual provider Active NPI

David Gary Jupiter, OD

  • Optometrist
  • Wilmington, DE
National Provider Identifier
1780794024
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA1248 Issued in MD
Practice address
2500 Grubb Rd
Wilmington, DE 19810-4799
Phone
(302) 475-6500
Fax
(302) 475-9528
NPI assigned
Aug 30, 2006
Last updated
Jun 16, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA1248 MD Primary

Addresses

Primary practice location

2500 Grubb Rd
Wilmington, DE 19810-4799

Mailing address

2500 Grubb Rd
Wilmington, DE 19810-4799
Phone (302) 475-6500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080425000222 DE Practitioner - Optometry 2860570926 Reassigns benefits to 1 organization
I20191112000077 MD Practitioner - Optometry 2860570926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Douglas J Lavenburg MD PAGroup PAC ID 3476549098, 6 clinicians

Practice addresses (Care Compare)

1 Centurian Dr
Suite 114
Newark, DE 19713-2154
Phone (410) 392-6133

103 Chesapeake Blvd
Elkton, MD 21921-6391
Phone (410) 392-6133

Merit-based Incentive Payment System (MIPS)

Final score
92.15 of 100Reported as group
Quality
100
Improvement activities
40
Cost
73.82

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Douglas J Lavenburg MD PA Optometrist CurrentSince Oct 28, 2019 Accepting new patients

Locations

1 Centurian Dr
Ste 114
Newark, DE 19713
Phone (302) 993-0722

103 Chesapeake Blvd
Ste C
Elkton, MD 21921
Phone (410) 392-6133

Interoperability endpoints

  • Direct secure messaging: dgjupiter@lavenburg.direct.eyemdemr.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213574400000",
    "number": "1780794024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 GRUBB RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198104799",
            "telephone_number": "302-475-6500",
            "fax_number": "302-475-9528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 GRUBB RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198104799",
            "telephone_number": "302-475-6500",
            "fax_number": "302-475-9528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUPITER",
        "first_name": "DAVID",
        "middle_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.