GUY ANDREW DIETELS, O.D. — NPI 1902855414 (Licensed & Credentialed Eye and Vision Service Providers — Optometrist, Corneal and Contact Management in ROANOKE, VA)

CMS-1500 Box 24J / 33a • NPI

1902855414

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

152WC0802X (CMS 41)

Licensed & Credentialed Eye and Vision Service Providers — Optometrist, Corneal and Contact Management

Box 32 Service Location & ZIP+4

1455 TOWNE SQUARE BLVD NW, ROANOKE, VA, 24012-1612

✓ 9-Digit EDI 837 ZIP+4 (24012-1612)

Practice Phone & Referral Fax

(540) 265-0595

Fax: (540) 265-0596

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1902855414 (GUY ANDREW DIETELS, O.D.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1902855414` (NPI-1 Individual Practitioner)
Provider / Legal Name	GUY ANDREW DIETELS, O.D.
Plain-English Specialty	Licensed & Credentialed Eye and Vision Service Providers — Optometrist, Corneal and Contact Management NUCC Code: `152WC0802X` (Optometrist, Corneal and Contact Management)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	1455 TOWNE SQUARE BLVD NW, ROANOKE, VA, 24012-1612
Practice Telephone / Fax	Tel: (540) 265-0595 \| Fax: (540) 265-0596
Administrative Mailing Address	75 BITTERSWEET LN, HARDY, VA, 24101-3333
Enumeration & Last Sync	Enumerated: 2006-05-10 \| CMS Record Updated: 2008-07-18

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1455 TOWNE SQUARE BLVD NW, ROANOKE, VA, 24012-1612

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Plain-English Taxonomy & CMS Crosswalk (152WC0802X)

What Does Taxonomy Code 152WC0802X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 152WC0802X translates to:
"Licensed & Credentialed Eye and Vision Service Providers — Optometrist, Corneal and Contact Management"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 41 (Optometry)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Optometrist, Corneal and Contact Management for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (GUY ANDREW DIETELS, O.D.)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`152WC0802X` — Optometrist, Corneal and Contact Management Plain English: Licensed & Credentialed Eye and Vision Service Providers — Optometrist, Corneal and Contact Management	State: VA \| License: `061800456` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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GUY ANDREW DIETELS, O.D. (NPI #1902855414)