Individual provider Active NPI

Daniel T Brown, OD

  • Optometrist
  • Melbourne, FL
National Provider Identifier
1497706808
Registry record updated Feb 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC2649 Issued in FL
Practice address
502 E New Haven Ave
Melbourne, FL 32901-5427
Phone
(321) 727-2020
Fax
(321) 984-9547
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC2649 FL Primary

Addresses

Primary practice location

502 E New Haven Ave
Melbourne, FL 32901-5427

Mailing address

502 E. New Haven Ave
Melbourne, FL 32901-5427
Phone (321) 727-2020

Other identifiers 5

IdentifierTypeStateIssuer
20409OtherFLBLUE CROSS / BLUE SHIELD
5962549OtherFLAETNA PPO
2527938OtherFLAETNA HMO
410040081OtherFLRAILROAD MEDICARE
070214500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100723000123 FL Practitioner - Optometry 3476685629

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.79 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
79.31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC2649FLMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486080000000",
    "number": "1497706808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 E. NEW HAVEN AVE",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329015427",
            "telephone_number": "321-727-2020",
            "fax_number": "321-984-9547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 E NEW HAVEN AVE",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329015427",
            "telephone_number": "321-727-2020",
            "fax_number": "321-984-9547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "DANIEL",
        "middle_name": "T",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2017-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS / BLUE SHIELD",
            "identifier": "20409",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "5962549",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2527938",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410040081",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070214500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.