Daniel L Dale, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

30832 Issued in WI

Practice address

1525 Park Place
Green Bay, WI 54304-1979

Phone

(920) 965-1234

Fax

(920) 965-1232

NPI assigned

Jun 13, 2005

Last updated

Jan 26, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fox Valley Urological Associates SC

  • Urology Physician
  • Appleton, WI
  • NPI 1356601587
  NPD (past)
• Park Place Optical, LTD

  • Optician
  • Appleton, WI
  • NPI 1255465738
  NPD (past)
• Woodland Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Appleton, WI
  • NPI 1245297662
  NPD (past)

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264464000000",
    "number": "1326042730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 PARK PLACE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543041979",
            "telephone_number": "920-965-1234",
            "fax_number": "920-965-1232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 PARK PLACE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543041979",
            "telephone_number": "920-965-1234",
            "fax_number": "920-965-1232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALE",
        "first_name": "DANIEL",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2010-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "30832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3167500",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NCS",
            "identifier": "5966510002",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "161633405011",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jean Dahlstrom, PHYSICAL THERAPIST
• Mathias Dahnert, P.A.
• Wolfgang F Dahnert, MD
• Louis Alan Dainty, MD
• Charles F Dais II, M.D.
• James G Dalebroux, RN
• Katie Dalebroux, PHARMD
• Jenna Mae Dalgord, MSW, APSW, SAC-IT
• Kelly Dallaire, LPC
• Sarah Dallas, COTA

• Ophthalmology Physician in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Ophthalmology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.