Individual provider Active NPI

Daniel D Coyle, OD

  • Optometrist
  • Summerville, SC
National Provider Identifier
1467411181
Registry record updated Dec 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
825 Issued in SC
Practice address
174 Beauregard Rd
Summerville, SC 29483-2089
Phone
(843) 821-0261
Fax
(843) 821-0283
NPI assigned
Mar 21, 2006
Last updated
Dec 3, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 825 SC Primary

Addresses

Primary practice location

174 Beauregard Rd
Summerville, SC 29483-2089

Mailing address

174 Beauregard Rd
Summerville, SC 29483-2089
Phone (843) 821-0261

Other identifiers 1

IdentifierTypeStateIssuer
D08258MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20050103000816 SC Practitioner - Optometry 0749248003 Reassigns benefits to 1 organization
Practice locations: Summerville, SC

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lowcountry Eye Care of Cane Bay LLCGroup PAC ID 3779857412, 7 clinicians

Practice addresses (Care Compare)

174 Beauregard Rd
Summerville, SC 29486-2089
Phone (843) 821-0261

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
825SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Lowcountry Eye Care of Cane Bay, LLC Optometrist CurrentSince Nov 9, 2022 Accepting new patients

Locations

102 Greenland Dr
Goose Creek, SC 29445
Phone (843) 797-1264

1718 State Rd
Ste 8D
Summerville, SC 29486
Phone (843) 797-1264

174 Beauregard Rd
Summerville, SC 29486
Phone (843) 821-0261

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228262400000",
    "number": "1467411181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 BEAUREGARD RD",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294832089",
            "telephone_number": "843-821-0261",
            "fax_number": "843-821-0283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 BEAUREGARD RD",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294832089",
            "telephone_number": "843-821-0261",
            "fax_number": "843-821-0283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COYLE",
        "first_name": "DANIEL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2008-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D08258",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.