Individual provider Active NPI

Daniel G. Pisacano, O.D.

  • Optometrist
  • Oswego, NY
National Provider Identifier
1629047840
Registry record updated Dec 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
VUT 6120 Issued in NY
Practice address
341 State Route 104
Vision Center
Oswego, NY 13126-2911
Phone
(315) 207-7044
Fax
(315) 343-5165
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X VUT 6120 NY Primary

Addresses

Primary practice location

341 State Route 104
Vision Center
Oswego, NY 13126-2911

Mailing address

9602 Dunderry HTS
Baldwinsville, NY 13027-9082
Phone (315) 720-3988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20080213000326 NY Practitioner - Optometry 6204886047 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dandb Optometry Associates PLLCGroup PAC ID 7012182934, 2 clinicians

Practice addresses (Care Compare)

341 State Route 104
Oswego, NY 13126-2911
Phone (315) 207-7044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
VUT 6120NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
D&B Optometry Associates PLLC Optometrist CurrentSince Jul 8, 2011 Accepting new patients
Valley Vision Care, P.C. Optometrist Past Accepting new patients
Daniel Kohansby, O.D. PC Optometrist PastSince Oct 18, 2016 Accepting new patients

Locations

1818 State Route 3
Fulton, NY 13069
Phone (315) 598-1669

8770 Dell Center Dr
Liverpool, NY 13090
Phone (315) 622-5405

341 State Route 104
Oswego, NY 13126
Phone (315) 207-7044

Organizations & group practices 3

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": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482451200000",
    "number": "1629047840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9602 DUNDERRY HTS",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130279082",
            "telephone_number": "315-720-3988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 STATE ROUTE 104",
            "address_2": "VISION CENTER",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131262911",
            "telephone_number": "315-207-7044",
            "fax_number": "315-343-5165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PISACANO",
        "first_name": "DANIEL",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2016-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "VUT 6120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, NY

Sources for this page

Verify at the official NPI Registry.