Daniel Wayne Donaldson II, O.D.
Individual provider Active NPI Optometrist · Martin, TN
NPI 1376562009 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1376562009
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 2595 (TN)
- Practice address
- 134 Courtright Rd
Martin, TN 38237-1606 - Phone
- (731) 588-5744
- Fax
- (731) 588-5753
- NPI assigned
- Jul 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Southern College of Optometry, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Eyecare Center, LLC
Practice addresses (Care Compare)
142 Mount Pelia Rd
Martin, TN 38237-3812
Phone (731) 587-3555
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 68 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- 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 |
|---|---|---|---|---|
| I20080714000608 | TN | Practitioner - Optometry | 9436221124 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eyecare Center, LLC | Optometrist | Current |
Accepting new patients |
| Paris Eye Care, LLC | Optometrist | Past | Accepting new patients |
Locations
107 Kennedy Dr
Martin, TN 38237
Phone (731) 587-3555
142 Mount Pelia Rd
Martin, TN 38237
Phone (731) 587-3555
Interoperability endpoints
- drdannyd@direct.revolutionehr.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2595 | TN | Yes |
Addresses
Primary practice location
134 Courtright Rd
Martin, TN 38237-1606
Mailing address
114 Rolling MDWS
Martin, TN 38237-5706
Phone (731) 225-4128
Other providers in Martin, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.