Dr Chris E Deitrick, OD is a medicare enrolled "Optometrist" provider in Mountain View, Arkansas. He went to Southern College Of Optometry and graduated in 2001 and has 23 years of diverse experience with area of expertise as Optometry. He is a member of the group practice Chris Deitrick Od Pa and his current practice location is
101 Case Commons Dr., Mountain View, Arkansas. You can reach out to his office (for appointments etc.) via phone at
(870) 269-3610.
Dr Chris E Deitrick is licensed to practice in Arkansas (license number 2516) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1669470183.
Healthcare Provider's Profile
| Full Name | Dr Chris E Deitrick |
|---|
| Gender | Male |
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| Speciality | Optometry |
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| Experience | 23 Years |
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| Location | 101 Case Commons Dr., Mountain View, Arkansas |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Chris E Deitrick attended and graduated from Southern College Of Optometry in 2001
NPI Data:
- NPI Number: 1669470183
- Provider Enumeration Date: 07/08/2005
- Last Update Date: 08/14/2023
Medicare PECOS Information:
- PECOS PAC ID: 2466448394
- Enrollment ID: I20040423001378
Medical Identifiers
Medical identifiers for Dr Chris E Deitrick such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1669470183 | NPI | - | NPPES |
| 431988740 | Other | AR | TAX ID # |
| 145299722 | Medicaid | AR | |
| 4709560001 | Other | AR | MEDICARE DMEPOS ID # |
| 19930000041 | Other | AR | QUALCHOICE ID # |
| 410049416 | Other | AR | MEDICARE RR ID# |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152WC0802X | Optometrist - Corneal And Contact Management | 2516 (Arkansas) | Secondary |
| 152W00000X | Optometrist | 2516 (Arkansas) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Chris Deitrick Od Pa | 6204725971 | 2 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Chris E Deitrick allows following entities to bill medicare on his behalf.
| Provider Name | Chris Deitrick Od Pa |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1780773481
PECOS PAC ID: 6204725971
Enrollment ID: O20040311000750 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Chris E Deitrick is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Chris E Deitrick, OD
Po Box 1460, 101 Case Commons Drive,
Mountain View, AR 72560-1460
Ph: (870) 269-3610 | Dr Chris E Deitrick, OD
101 Case Commons Dr.,
Mountain View, AR 72560
Ph: (870) 269-3610 |
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