Macy Dieleman, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

083098 Issued in IA

Practice address

718 Story St
Boone, IA 50036-2834

Phone

(515) 432-2020

Fax

(515) 432-8482

NPI assigned

Jul 21, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Macy Fickbohm Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IA

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Elite Eye Care PC 10 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Elite Eye Care PC

  • Optometrist
  • Waukee, IA
  • NPI 1700103850

  IA

  Medicare reassignment Care Compare group
• KNJ Optometry PLC

  • Optometrist
  • Ankeny, IA
  • NPI 1568819647
  NPD
• McFarland Clinic, PC

  • Eyewear Supplier
  • Boone, IA
  • NPI 1528149457

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1469059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609113600000",
    "number": "1891148151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 DUFF AVE",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500105469",
            "telephone_number": "515-239-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 STORY ST",
            "city": "BOONE",
            "state": "IA",
            "postal_code": "500362834",
            "telephone_number": "515-432-2020",
            "fax_number": "515-432-8482"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "718 Story St",
            "address_purpose": "LOCATION",
            "city": "Boone",
            "state": "IA",
            "postal_code": "50036",
            "country_code": "US",
            "telephone_number": "515-432-2020",
            "fax_number": "515-432-8482",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIELEMAN",
        "first_name": "MACY",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-21",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "083098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1219526",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdieleman102158@directmcfarlandclinic.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "718 Story St",
            "city": "Boone",
            "state": "IA",
            "country_code": "US",
            "postal_code": "500362834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MACY",
            "last_name": "FICKBOHM",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jacy Cornelis
• County Community Services
• Adriana Cullinan, DPT
• Gena Marie Daly, D.C
• Angela L. Devries, RPH
• Katherine M Dinges, LCSW
• Allison M Dovre
• Frank Downs, MD
• Brent Allen Drzycimski, DPT
• Devi Dunker, D.O.

• All providers in Boone, IA
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.