NPIMap

Individual provider Active NPI

Brandon J Dahl, O.D.

  • Optometrist
  • Fort Irwin, CA
National Provider Identifier
1821227257
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5070252-9934 Issued in UT
Practice address
BLG 170
Fort Irwin, CA 92310
Phone
(760) 380-3139
NPI assigned
Jul 7, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5070252-9934 UT Primary

Addresses

Primary practice location

BLG 170
Fort Irwin, CA 92310

Mailing address

BLG 170
Fort Irwin, CA 92310
Phone (760) 380-3139

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bdahl282520@direct.med.utah.edu Direct University of Utah Adult Services

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180131001741 UT Practitioner - Optometry 6103009014 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

65 S Mario Capecchi Dr
Salt Lake City, UT 84132-0005
Phone (801) 581-2352

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.77 of 100Reported as group
Quality
91.47
Promoting interoperability
100
Improvement activities
40
Cost
74.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5070252-9934UTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah CurrentSince Jan 25, 2018 Accepting new patients
University of Utah Adult Services CurrentSince Jan 1, 2018 Accepting new patients
University of Utah Adult Services Current Accepting new patients
University of Utah CurrentSince Jan 25, 2018 Accepting new patients
University of Utah Adult Services CurrentSince Jan 1, 2018 Accepting new patients
Bronson Lakeview Hospital Past Accepting new patients

Locations

165 N University Ave
Farmington, UT 84025
Phone (801) 213-3200

65 S Mario Capecchi Dr
Salt Lake City, UT 84132
Phone (801) 581-2352

127 S 500 E
Ste 400B
Salt Lake City, UT 84102
Phone (801) 587-6478

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Interoperability endpoints

  • Direct secure messaging: bdahl282520@direct.med.utah.edu

Organizations & group practices 6

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 3

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": "1246924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1821227257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BLG 170",
            "city": "FORT IRWIN",
            "state": "CA",
            "postal_code": "92310",
            "telephone_number": "760-380-3139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLG 170",
            "city": "FORT IRWIN",
            "state": "CA",
            "postal_code": "92310",
            "telephone_number": "760-380-3139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHL",
        "first_name": "BRANDON",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-07",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "5070252-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bdahl282520@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah Adult Services",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Irwin, CA

Sources for this page

Verify at the official NPI Registry.