Active NPI
Daniel William Doberneck, O.D.
- Optometrist
- Lewistown, PA
National Provider Identifier
1063543098
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OEG000545
- Practice address
- 25 N Main St
Lewistown, PA 17044-1746 - Phone
- (717) 242-3590
- Fax
- (717) 242-3590
- NPI assigned
- Mar 9, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OEG000545 | PA | Primary |
Addresses
Primary practice location
25 N Main St
Lewistown, PA 17044-1746
Mailing address
10 Moonbeam Dr
Lewistown, PA 17044-8115
Phone (717) 248-1108
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OEG000545 | PA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063543098",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 MOONBEAM DR",
"city": "LEWISTOWN",
"state": "PA",
"postal_code": "170448115",
"telephone_number": "717-248-1108",
"fax_number": "717-242-3590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 N MAIN ST",
"city": "LEWISTOWN",
"state": "PA",
"postal_code": "170441746",
"telephone_number": "717-242-3590",
"fax_number": "717-242-3590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOBERNECK",
"first_name": "DANIEL",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PA",
"license": "OEG000545",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lewistown, PA
- Diakon Lutheran Social Ministries (Ohesson Manor)
- Kadiatou Diallo-Bangurah, PMHNP
- Abigail Frances Digilio, PT
- Harry Edward Dilcher, M.D.
- Harry Heasley Dinsmore Jr., MD
- Karen Graham Doberneck, PHD, BCBA-D
- Tasha L Dodd, PA-C
- Vsevolod Dounaevski, MD
- Dr. Frank Grill OB/GYN LLC
- Drayer Physical Therapy Institute LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.