Individual provider Active NPI

Danielle Callegari

  • Optometrist
  • Jacksonville, FL
National Provider Identifier
1013269661
Registry record updated Oct 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC4754 Issued in FL
Practice address
9041 Southside Blvd
Jacksonville, FL 32256-5484
Phone
(904) 519-5057
NPI assigned
Oct 5, 2012
Last updated
Oct 5, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC4754 FL Primary

Addresses

Primary practice location

9041 Southside Blvd
Jacksonville, FL 32256-5484

Mailing address

9041 Southside Blvd
Jacksonville, FL 32256-5484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20140328000773 FL Practitioner - Optometry 6204067614 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlantic Eye Institute, P.a.Group PAC ID 2466434386, 10 clinicians

Practice addresses (Care Compare)

3316 3Rd St S
Suite 103
Jacksonville, FL 32250-6090
Phone (904) 241-7865

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC4754FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Harris Wilcox and Donovan PA Optometrist Current Accepting new patients
Atlantic Eye Institute, P.a. Optometrist CurrentSince May 1, 2014 Accepting new patients
Atlantic Eye Institute P.a. CurrentSince May 1, 2014 Accepting new patients
Harris Wilcox and Donovan PA CurrentSince Oct 1, 2021 Accepting new patients
Harris Wilcox and Donovan P a Optometrist CurrentSince Oct 1, 2021 Accepting new patients

Locations

6207 Bennett Rd
Jacksonville, FL 32216
Phone (904) 241-7865

3316 3rd St S
Ste 103
Jax Bch, FL 32250
Phone (904) 241-7865

2023 Professional Center Dr
Orange Park, FL 32073
Phone 9042722020234

105 Nature Walk Pkwy
St Augustine, FL 32092
Phone (904) 241-7865

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1349395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349395200000",
    "number": "1013269661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9041 SOUTHSIDE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322565484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9041 SOUTHSIDE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322565484",
            "telephone_number": "904-519-5057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLEGARI",
        "first_name": "DANIELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-05",
        "last_updated": "2012-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.