David Ray Haisman, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

002415 Issued in IA

Practice address

2200 17TH St
Spirit Lake, IA 51360

Phone

(712) 336-8939

Fax

(712) 336-8952

NPI assigned

Oct 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Undefined Non-Physician Type (Specify)

Education

Illinois College of Optometry at Chicago, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Avera MarshallGroup PAC ID 5799695227, 102 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Avera Marshall

  • Critical Access Hospital
  • Marshall, MN
  • NPI 1568401016
  Medicare reassignment Care Compare group NPD
• Avera Marshall

  • Optometrist
  • Marshall, MN
  • NPI 1487422465
  NPD
• Avera Marshall

  • Physical Therapist
  • Marshall, MN
  • NPI 1659838290
  NPD
• Avera Marshall

  • Multi-Specialty Clinic/Center
  • Marshall, MN
  • NPI 1962641936
  NPD (past)

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402963200000",
    "number": "1104902923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 17TH ST",
            "city": "SPIRIT LAKE",
            "state": "IA",
            "postal_code": "51360",
            "telephone_number": "712-336-8939",
            "fax_number": "712-336-8952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 17TH ST",
            "city": "SPIRIT LAKE",
            "state": "IA",
            "postal_code": "51360",
            "telephone_number": "712-336-8939",
            "fax_number": "712-336-8952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAISMAN",
        "first_name": "DAVID",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2014-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009582",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "002415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Great Lakes Physical Therapy, PC
• Great Lakes Physical Therapy, PC
• Patti Ann Griffiths, RPH
• Joey Leigh Gude, LMHC(T)
• Marsha Kay Haar, FNP-C
• David Jon Halland, PT
• Jason Roger Hamm, D.C.
• Amy Erika Hartzell, DDS
• Brent Haugle, MS, RD, LD
• Hawkeye Care Center of Spirit Lake, LLC

• Optometrist in Spirit Lake, IA
• Providers in Spirit Lake, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2014; 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.