John T. Danielson, O.D.
Individual provider Active NPI Optometrist · Wilbraham, MA
NPI 1629072178 · NPPES record last updated May 14, 2010
Key facts
- NPI
- 1629072178
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 2602 (MA)
- Practice address
- 1964 Boston Rd
Wilbraham, MA 01095-1055 - Phone
- (413) 543-5444
- Fax
- (413) 543-5444
- NPI assigned
- Jun 10, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2602 | MA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| RMK Holyoke Optical Inc | Past | Accepting new patients | |
| Danielson Eye Care | Optometrist | Past | Accepting new patients |
| Neuro-Ophthalmology & Eyecare PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2602 | MA | Yes |
Addresses
Primary practice location
1964 Boston Rd
Wilbraham, MA 01095-1055
Mailing address
1964 Boston Rd
Wilbraham, MA 01095-1055
Phone (413) 543-5444
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110014431A | Medicaid | MA | |
| 110014431B | Medicaid | MA |
Other providers in Wilbraham, MA
- CVS Pharmacy Inc
- Joseph Anthony D'Agostino
- Nicole Dacampo
- Siobhan Carin Daley
- Danielson Eye Care
- Carol Davis
- Martha Yvette Davis
- Laura Ruth Dayton
- Drew Dearden
- Dermatology and Laser Center of Western Mass Inc
All providers in Wilbraham, MA · Optometrist in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 14, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.