Individual provider Active NPI

Daniel P Taylor, O. D.

  • Optometrist
  • Fort Wayne, IN
National Provider Identifier
1043270812
Registry record updated Aug 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18002712A Issued in IN
Practice address
431 W Coliseum Blvd
Fort Wayne, IN 46805
Phone
(260) 484-8516
Fax
(260) 484-8521
NPI assigned
Mar 25, 2006
Last updated
Aug 15, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18002712A IN Primary

Addresses

Primary practice location

431 W Coliseum Blvd
Fort Wayne, IN 46805

Mailing address

431 W Coliseum Blvd
Fort Wayne, IN 46805-1010
Phone (260) 484-8516

Other identifiers 1

IdentifierTypeStateIssuer
200125690MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20100227000051 IN Practitioner - Optometry 4880739051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Eye Consultants PCGroup PAC ID 2961399217, 71 clinicians

Practice addresses (Care Compare)

301 J St
La Porte, IN 46350-4734
Phone (219) 362-8923

431 W Coliseum
Fort Wayne, IN 46805-1010
Phone (260) 484-8516

Merit-based Incentive Payment System (MIPS)

Final score
55.99 of 100Reported as group
Quality
31.67
Improvement activities
40
Cost
78.58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18002712AINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Eye Consultants, P.C. Optometrist Past Accepting new patients
Midwest Eye Consultants, P.C. Optometrist Past Accepting new patients
Midwest Eye Consultants P.C. Optometrist Past Accepting new patients
Midwest Eye Consultants, P.C. Optometrist Past Accepting new patients

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": "1143244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1043270812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 W COLISEUM BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468051010",
            "telephone_number": "260-484-8516",
            "fax_number": "260-484-8521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 W COLISEUM BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46805",
            "telephone_number": "260-484-8516",
            "fax_number": "260-484-8521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "DANIEL",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "O. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-25",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002712A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200125690",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.