Individual provider Active NPI

Andrea Michelle Dinovo, O.D.

  • Optometrist
  • Delaware, OH
National Provider Identifier
1821080151
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5382 Issued in OH
Practice address
115 N Sandusky St
Delaware, OH 43015-1732
Phone
(740) 513-4750
Fax
(740) 513-4760
NPI assigned
Aug 23, 2005
Last updated
Dec 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5382 OH Primary

Addresses

Primary practice location

115 N Sandusky St
Delaware, OH 43015-1732

Mailing address

1832 Castleton Way
Delaware, OH 43015-1301
Phone (740) 363-2015

Other identifiers 1

IdentifierTypeStateIssuer
2522274MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20041116001048 OH Practitioner - Optometry 1456315746 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Delaware Eyes LLCGroup PAC ID 9234529975, 2 clinicians

Practice addresses (Care Compare)

115 N Sandusky St
Delaware, OH 43015-1732
Phone (740) 513-4750

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5382OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Delaware Eyes LLC Optometrist CurrentSince Nov 15, 2021 Accepting new patients
Myeyedr Optometry of Ohio, LLC Optometrist CurrentSince Jun 24, 2019 Accepting new patients
Myeyedr Optometry of Ohio, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Ohio, LLC Optometrist CurrentSince Jun 24, 2019 Accepting new patients

Locations

115 N Sandusky St
Delaware, OH 43015
Phone (740) 513-4750

1723 Marion Mount Gilead Rd
Marion, OH 43302
Phone (740) 387-6880

8254 Mayberry Sq N
Sylvania, OH 43560
Phone (419) 885-5300

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

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, 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": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1821080151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1832 CASTLETON WAY",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430151301",
            "telephone_number": "740-363-2015",
            "fax_number": "740-369-2408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 N SANDUSKY ST",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430151732",
            "telephone_number": "740-513-4750",
            "fax_number": "740-513-4760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINOVO",
        "first_name": "ANDREA",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-23",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2522274",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Delaware, OH

Sources for this page

Verify at the official NPI Registry.