Individual provider Active NPI

Daniel B Drysdale, M.D. PC

  • Ophthalmology Physician
  • Blacksburg, VA
National Provider Identifier
1629013776
Registry record updated Oct 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
0101029249 Issued in VA
Practice address
3645 S Main St
Blacksburg, VA 24060-7018
Phone
(540) 951-0525
Fax
(540) 953-1539
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 0101029249 VA Primary

Addresses

Primary practice location

3645 S Main St
Blacksburg, VA 24060-7018

Mailing address

3645 S Main St
Blacksburg, VA 24060-7018
Phone (540) 951-0525

Other identifiers 3

IdentifierTypeStateIssuer
064462OtherVAANTHEM PROVIDER NUMBER
006374760MedicaidVA
1952631723OtherVATYPE II DME NPI CORPORATE DMERC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111213000187 VA Practitioner - Ophthalmology 6103895842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Duke University School of Medicine, 1974
Medicare assignment
May accept Medicare assignment
Group practices
Old Dominion Eye Care IncGroup PAC ID 8527009364, 3 clinicians

Practice addresses (Care Compare)

101 Technology Park Dr
Kilmarnock, VA 22482-3837
Phone (804) 435-0547

Merit-based Incentive Payment System (MIPS)

Final score
23.63 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
78.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101029249VAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Old Dominion Eye Care Inc Ophthalmology CurrentSince Jan 1, 2025 Accepting new patients

Locations

101 Technology Park Dr
Kilmarnock, VA 22482
Phone (804) 435-0547

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318464000000",
    "number": "1629013776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3645 S MAIN ST",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240607018",
            "telephone_number": "540-951-0525",
            "fax_number": "540-953-1539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3645 S MAIN ST",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240607018",
            "telephone_number": "540-951-0525",
            "fax_number": "540-953-1539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRYSDALE",
        "first_name": "DANIEL",
        "middle_name": "B",
        "credential": "M.D. PC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2011-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0101029249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "064462",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006374760",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE II DME NPI CORPORATE DMERC",
            "identifier": "1952631723",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blacksburg, VA

Sources for this page

Verify at the official NPI Registry.