Individual provider Active NPI

Daniel O'Connor, OD

  • Optometrist
  • Paducah, KY
National Provider Identifier
1184398026
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2352DT Issued in KY
Practice address
4630 Village Square Dr
Paducah, KY 42001-7502
Phone
(270) 442-1671
NPI assigned
Aug 4, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18004298A IN
Optometrist 152W00000X 2352DT KY Primary

Addresses

Primary practice location

4630 Village Square Dr
Paducah, KY 42001-7502

Mailing address

714 Kossuth St
Lafayette, IN 47905-1447

Other practice location 1

466 S Indiana St
Mooresville, IN 46158-1710
Phone (317) 271-7296

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20230823000943 KY Practitioner - Optometry 6608271952 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Ophthalmology Group LLCGroup PAC ID 0840227013, 5 clinicians

Practice addresses (Care Compare)

4630 Village Square Dr
Suite 100
Paducah, KY 42001-7502
Phone (270) 443-4393

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.22 of 100Reported as group
Quality
100
Improvement activities
40
Cost
77.41

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2352DTKYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
The Ophthalmology Group, LLC Optometrist CurrentSince Sep 18, 2023 Accepting new patients

Locations

4630 Village Square Dr
Paducah, KY 42001
Phone (270) 442-1671

4630 Village Square Dr
Ste 100
Paducah, KY 42001
Phone (270) 443-4393

Interoperability endpoints

  • Direct secure messaging: doconnor@paducaheyes.intellechartdirect.net

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1628035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1184398026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 KOSSUTH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479051447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4630 VILLAGE SQUARE DR",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420017502",
            "telephone_number": "270-442-1671"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "466 S Indiana St",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "IN",
            "postal_code": "461581710",
            "country_code": "US",
            "telephone_number": "317-271-7296",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-04",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004298A",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "2352DT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

Verify at the official NPI Registry.