Mary Reed Dacanal, OD Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG000721 Issued in PA

Legal business name

MARY REED DACANAL, OD INC.

Practice address

516 Market St
Johnsonburg, PA 15845-1240

Phone

(814) 965-3231

Fax

(814) 965-5483

NPI assigned

Jul 19, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mary Reed Dacanal, OD

Title

Optometrist/Owner

Phone

(814) 965-3231

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 2

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

• Mary Terese Dacanal, O.D.

  • Optometrist
  • Johnsonburg, PA
  • NPI 1528054285
  Medicare reassignment Care Compare group NPD
• Kara Detsch

  • Optometrist
  • Ridgway, PA
  • NPI 1396500328
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235088000000",
    "number": "1013117019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 MARKET ST",
            "city": "JOHNSONBURG",
            "state": "PA",
            "postal_code": "158451240",
            "telephone_number": "814-965-3231",
            "fax_number": "814-965-5483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 MARKET ST",
            "city": "JOHNSONBURG",
            "state": "PA",
            "postal_code": "158451240",
            "telephone_number": "814-965-3231",
            "fax_number": "814-965-5483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY REED DACANAL, OD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-19",
        "last_updated": "2009-02-20",
        "status": "A",
        "authorized_official_last_name": "DACANAL",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "REED",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "814-965-3231",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID-TYPE UNSPECIF",
            "identifier": "069767",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012058380001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debra Jacob, RDHBS, PHDHP
• Johnsonburg Area School District
• Johnsonburg Dental Center
• Johnsonburg Fire Department
• Johnsonburg Physical Therapy & Fitness Center Inc
• Carolyn Karafiath Miller, PA-C
• Naila Naseem-Elkassas, D.D.S.
• Pennsylvania CVS Pharmacy, L.L.C.
• Taylor Marie Scida, RDH, PHDHP
• Cheryl Shrubb

• Optometrist in Johnsonburg, PA
• Providers in Johnsonburg, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.