Daniel Joseph Vidlak, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2643ATI Issued in OR

Practice address

1022 NW 6TH Street
Grants Pass, OR 97526

Phone

(541) 476-4545

NPI assigned

Oct 3, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Care Group of Southern Oregon LLCGroup PAC ID 4082629290, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: danv@eyecaregroupofsouthernoregon.emadirect.md

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.

• Eye Care Group of Southern Oregon, LLC

  dba Eye Care Group

  • Optometrist
  • Grants Pass, OR
  • NPI 1306988787
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1477648772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1022 NW 6TH STREET",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "97526",
            "telephone_number": "541-476-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1022 NW 6TH STREET",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "97526",
            "telephone_number": "541-476-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDLAK",
        "first_name": "DANIEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2643ATI",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150462",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2643ATI",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Vermeer
• Michelle L Vermeer, RN
• Nicole J L Vernier, CADC I
• Douglas Matthew Vetsch
• Haley Mae Vicari
• Susan Lorraine Viegas, RN
• Crystian Villa, QMHA
• Aundrea Villanueva
• Kyle James Villaruz, DPM
• Rachel Villaruz, PA

• Optometrist in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.

Verify at the official NPI Registry.