Active NPI
Joseph P Dale, OD
- Optometrist
- Bicknell, IN
National Provider Identifier
1316939747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 18002783
- Practice address
- 610 West 11TH Street
Bicknell, IN 47512-9600 - Phone
- (812) 735-4834
- Fax
- (812) 735-4932
- NPI assigned
- Aug 22, 2005
- 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 | 18002783 | IN | Primary |
Addresses
Primary practice location
610 West 11TH Street
Bicknell, IN 47512-9600
Mailing address
610 W 11TH St
Bicknell, IN 47512-9627
Phone (812) 735-4834
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200070850 | Medicaid | IN | |
| 410036600 | Other | IN | RRMEDICARE |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110525000322 | IN | Practitioner - Optometry | 8224241302 |
Reassigns benefits to 1 organization Practice locations: Bicknell, IN |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Indiana University - School of Optometry, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
610 W 11TH St
Bicknell, IN 47512-9627
Phone (812) 735-4834
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 88 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18002783 | IN | MD | Optometrist |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372118400000",
"number": "1316939747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 W 11TH ST",
"city": "BICKNELL",
"state": "IN",
"postal_code": "475129627",
"telephone_number": "812-735-4834",
"fax_number": "812-735-4932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 WEST 11TH STREET",
"city": "BICKNELL",
"state": "IN",
"postal_code": "475129600",
"telephone_number": "812-735-4834",
"fax_number": "812-735-4932"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DALE",
"first_name": "JOSEPH",
"middle_name": "P",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-22",
"last_updated": "2013-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IN",
"license": "18002783",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200070850",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RRMEDICARE",
"identifier": "410036600",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bicknell, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2013; 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.