Del Opticians, LLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

4222 Issued in OH

Legal business name

DEL OPTICIANS, LLC

Practice address

1494 W Main St
Newark, OH 43055-1825

Phone

(740) 927-8152

NPI assigned

Sep 25, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Mark James Petrykowski, O.D.NPI 1811955347

Title

Owner

Phone

(740) 344-4747

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark James Petrykowski, O.D.

  • Optometrist
  • Newark, OH
  • NPI 1811955347

  OH, Optometrist

  Medicare reassignment NPD Authorized official
• Stephen J Grygier, O.D.

  • Optometrist
  • Marion, OH
  • NPI 1215032792
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256947200000",
    "number": "1851492763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1494 W MAIN ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551825",
            "telephone_number": "740-927-8152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1494 W MAIN ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551825",
            "telephone_number": "740-927-8152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEL OPTICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2009-10-31",
        "status": "A",
        "authorized_official_last_name": "PETRYKOWSKI",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "740-344-4747",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "OH",
            "license": "4222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0934958",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Faye Deck-Freas
• Sadie Ann Deckard, PA-C
• Maria M Defante, M.D.
• Mark T Defrancisco, DO
• Edward A Del Grosso, M.D.
• Paul Gaston Del Valle, M.D.
• John Scott Delong, DO
• Shelley Delucia
• Julie Alane Demaline, CRT, RCP
• Jacob Demaree, DC, RN

• All providers in Newark, OH
• Eyewear Supplier in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.