Mary Terese Dacanal, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG000721 Issued in PA

Practice address

516 Market St
Johnsonburg, PA 15845-1240

Phone

(814) 965-3231

NPI assigned

Sep 27, 2005

Last updated

Oct 22, 2012By the provider in NPPES

Sex

Female

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 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Pennsylvania College of Optometry, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mary Reed Dacanal, OD Inc.Group PAC ID 4880669290, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Mary Reed Dacanal, OD Inc.

  • Optometrist
  • Johnsonburg, PA
  • NPI 1013117019
  Medicare reassignment Care Compare group NPD
• Blake a Housler OD Inc

  dba Allegheny Eye Care

  • Optometrist
  • Kane, PA
  • NPI 1407046451
  NPD (past)

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1528054285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 MARKET ST",
            "city": "JOHNSONBURG",
            "state": "PA",
            "postal_code": "158451240",
            "telephone_number": "816-965-3231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 MARKET ST",
            "city": "JOHNSONBURG",
            "state": "PA",
            "postal_code": "158451240",
            "telephone_number": "814-965-3231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DACANAL",
        "first_name": "MARY",
        "middle_name": "TERESE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-27",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012058380001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul Allegretto, MSPT
• Jamie Rose Bon, PHARMD
• Amber Rose Bowser, D.O.
• Raymond John Butterfiled, PT
• James J Condon, DNP, CRNP, FNP-BC
• Petra Danielisz, M.D.
• Dubois Regional Medical Center (Johnsonburg Rural Health Center)
• Dubois Regional Medical Center - Penn Highlands Family Medicine (Penn Highlands DuBois)
• Elk Regional Health Center (Johnsonburg Rural Health Center)
• Elk Regional Professional Group Inc (Penn Highlands Professional Group Johnsonburg)

• Optometrist in Johnsonburg, PA
• Providers in Johnsonburg, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; 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.