Individual provider Active NPI

Terry E Daniel, O.D.

  • Optometrist
  • Berea, OH
National Provider Identifier
1609815844
Registry record updated Aug 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2940/T399 Issued in OH
Practice address
295 High St
Berea, OH 44017-1833
Phone
(440) 234-3800
Fax
(440) 234-2318
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2940/T399 OH Primary

Addresses

Primary practice location

295 High St
Berea, OH 44017-1833

Mailing address

295 High St
Berea, OH 44017-1833
Phone (440) 234-3800

Other identifiers 2

IdentifierTypeStateIssuer
11313346OtherOHCAQH
02855-00002OtherOHDMERC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20090312000007 OH Practitioner - Optometry 9638170566 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2940/T399OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Shirley R. Daniel, O.D. & Terry E. Daniel, O.D., Inc. Optometrist CurrentSince Dec 31, 1975 Accepting new patients

Locations

295 High St
Berea, OH 44017
Phone (440) 234-3800

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376438400000",
    "number": "1609815844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 HIGH ST",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440171833",
            "telephone_number": "440-234-3800",
            "fax_number": "440-234-2318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 HIGH ST",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440171833",
            "telephone_number": "440-234-3800",
            "fax_number": "440-234-2318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "TERRY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2013-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "2940/T399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11313346",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "02855-00002",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berea, OH

Sources for this page

Verify at the official NPI Registry.