Danielle Rae Johnson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODP-100539 Issued in ID

Practice address

8220 N Cornerstone Dr Ste a
Hayden, ID 83835-8683

Phone

(208) 772-5539

NPI assigned

Apr 13, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Dr. Danielle Rae Kolschefski Former name

Medicare fee-for-service enrollment

Enrolled in ID, NE, WA3 enrollments

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 3

Specialty

Optometry

Education

University of California - School of Optometry, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shoptikal LLCGroup PAC ID 1456684471, 192 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Shoptikal LLC

  • Eyewear Supplier
  • Coeur D Alene, ID
  • NPI 1063078442

  Optometrist

  Medicare reassignment Care Compare group NPD
• Breazeal & Associates PA Inc

  • Optometrist
  • Hayden, ID
  • NPI 1295005056
  Medicare reassignment NPD
• Aeg Washington Professional PC

  • Optometrist
  • Bellevue, WA
  • NPI 1134835176
  Medicare reassignment NPD
• Northeastern Washington Eyecare

  • Optometrist
  • Newport, WA
  • NPI 1629638929
  Medicare reassignment NPD
• Visionworks, Inc.

  • Optometrist
  • Omaha, NE
  • NPI 1619006327
  Medicare reassignment NPD
• Shoptikal LLC

  • Eyewear Supplier
  • Rockford, IL
  • NPI 1467311142

  Optometrist

  NPD
• Visionworks, Inc

  • Eyewear Supplier
  • Simpsonville, SC
  • NPI 1699571166
  NPD
• Fenno Eye Clinics Inc., P.S.

  • Optometrist
  • Colville, WA
  • NPI 1154463669
  NPD (past)

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

{
    "created_epoch": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1023637733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8220 N CORNERSTONE DR STE A",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838358683",
            "telephone_number": "208-772-5539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8220 N CORNERSTONE DR STE A",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838358683",
            "telephone_number": "208-772-5539"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Minor Lane",
            "address_purpose": "LOCATION",
            "city": "Berkeley",
            "state": "CA",
            "postal_code": "947200001",
            "country_code": "US",
            "telephone_number": "562-440-3222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "509 N Sullivan Rd",
            "address_purpose": "LOCATION",
            "city": "Spokane Valley",
            "state": "WA",
            "postal_code": "990378531",
            "country_code": "US",
            "telephone_number": "509-922-0633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DANIELLE",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-13",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "CA",
            "license": "34593",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CA430443",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "KOLSCHEFSKI",
            "middle_name": "RAE",
            "prefix": "DR.",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nanci Grayson Jenkins, M.S., RDN, LD
• Christy L Jenne, PHARMD
• Courtney Breann Jepson, LCSW
• John K. Hintz DDS, Ms, PA
• Kelly John
• Daryl Olaf Johnson, LMT
• Drew August Johnson, PA-C
• Heather Marie Johnson, LCSW
• Susan Johnson, RNFA
• Jennifer Alayne Jones

• Optometrist in Hayden, ID
• Providers in Hayden, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.