Individual provider Active NPI

Dana E Gillin, OD

  • Optometrist
  • Tecumseh, MI
National Provider Identifier
1013914225
Registry record updated Jul 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901003791 Issued in MI
Practice address
112 N Evans St
Suite 2
Tecumseh, MI 49286-1578
Phone
(517) 424-1010
Fax
(517) 592-5048
NPI assigned
Jul 1, 2005
Reactivated
Mar 27, 2006
Last updated
Jul 28, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901003791 MI Primary

Addresses

Primary practice location

112 N Evans St
Suite 2
Tecumseh, MI 49286-1578

Mailing address

112 N Evans St
Suite 2
Tecumseh, MI 49286-1578
Phone (517) 424-1010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20140827000106 MI Practitioner - Optometry 9931177177 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gillin Eye Care PCGroup PAC ID 7719103159, 2 clinicians

Practice addresses (Care Compare)

112 N Evans St
Tecumseh, MI 49286-1578
Phone (517) 424-1010

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901003791MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Gillin Eye Care PC Optometrist Current Accepting new patients
Dana E Gillin OD PC Optometrist PastSince Jun 3, 2005 Accepting new patients
Eric T. Anklin, OD, PC Optometrist PastSince Feb 28, 2014 Accepting new patients

Locations

112 N Evans St
Ste 2
Tecumseh, MI 49286
Phone (517) 424-1010

Organizations & group practices 3

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": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406505600000",
    "number": "1013914225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 N EVANS ST",
            "address_2": "SUITE 2",
            "city": "TECUMSEH",
            "state": "MI",
            "postal_code": "492861578",
            "telephone_number": "517-424-1010",
            "fax_number": "517-592-5048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 N EVANS ST",
            "address_2": "SUITE 2",
            "city": "TECUMSEH",
            "state": "MI",
            "postal_code": "492861578",
            "telephone_number": "517-424-1010",
            "fax_number": "517-592-5048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIN",
        "first_name": "DANA",
        "middle_name": "E",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2014-07-28",
        "deactivation_date": "2006-03-20",
        "reactivation_date": "2006-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tecumseh, MI

Sources for this page

Verify at the official NPI Registry.