Individual provider Active NPI

Daniel L Venarske, M.D

  • Allergy & Immunology Physician
  • Jackson, MS
National Provider Identifier
1003892357
Registry record updated Jan 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
16963 Issued in MS
Practice address
1513 Lakeland Dr.
Suite 101
Jackson, MS 39216
Phone
(601) 354-4836
Fax
(601) 354-2619
NPI assigned
Dec 19, 2005
Last updated
Jan 28, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 16963 MS Primary

Addresses

Primary practice location

1513 Lakeland Dr.
Suite 101
Jackson, MS 39216

Mailing address

1513 Lakeland Dr.,
Suite 101
Jackson, MS 39216
Phone (601) 354-4836

Other identifiers 1

IdentifierTypeStateIssuer
00125626MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050629000479 MS Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 9931145059 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Internal Medicine
Education
Baylor College of Medicine, 1995
Medicare assignment
May accept Medicare assignment
Group practices
Mississippi Asthma and Allergy Clinic PAGroup PAC ID 7416993522, 14 clinicians

Practice addresses (Care Compare)

1513 Lakeland Dr
Suite 101
Jackson, MS 39216-4829
Phone (601) 354-4836

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.53 of 100Reported as group
Quality
61.06
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mississippi Asthma & Allergy Clinic PA Allergy & Immunology CurrentSince Jul 5, 2005 Accepting new patients

Locations

1513 Lakeland Dr
Ste 101
Jackson, MS 39216
Phone (601) 354-4836

3704 Highway 39 N
Meridian, MS 39301
Phone (601) 693-0216

680 Highway 51
Ste B
Ridgeland, MS 39157
Phone (601) 856-0805

680 Highway 51
Ste D
Ridgeland, MS 39157
Phone (601) 898-1877

Networks

  • MS PPO
  • AL HMO D-SNP
  • devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
  • MS PPO C-SNP
  • LA PPO C-SNP
  • TN PPO C-SNP
  • MS PPO D-SNP
  • AL HMO
  • devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
  • devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
  • TN PPO

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264636800000",
    "number": "1003892357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1513 LAKELAND DR.,",
            "address_2": "SUITE 101",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39216",
            "telephone_number": "601-354-4836",
            "fax_number": "601-354-2619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1513 LAKELAND DR.",
            "address_2": "SUITE 101",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39216",
            "telephone_number": "601-354-4836",
            "fax_number": "601-354-2619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENARSKE",
        "first_name": "DANIEL",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2010-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "MS",
            "license": "16963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00125626",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.