Dan E Freeman, OD
Individual provider Active NPI Optometrist · Winfield, KS
NPI 1104893007 · NPPES record last updated Dec 17, 2013
Key facts
- NPI
- 1104893007
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 10322 (KS)
- Practice address
- 803 Main
Winfield, KS 67156 - Phone
- (620) 221-2020
- Fax
- (620) 221-7544
- NPI assigned
- Mar 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Southern College of Optometry, 1972
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
803 Main St
Winfield, KS 67156-2834
Phone (620) 221-2020
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050606000629 | KS | Practitioner - Optometry | 9830132380 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10322 | KS | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grene Vision Group LLC | Optometrist | Past | Accepting new patients |
| Grene Vision Group LLC | Optometrist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 10322 | KS | Yes |
Addresses
Primary practice location
803 Main
Winfield, KS 67156
Mailing address
803 Main
Winfield, KS 67156
Phone (620) 221-2020
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100090910B | Medicaid | KS |
Other providers in Winfield, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.