Individual provider Active NPI

Daniel R McCormack, D.O.

  • Allergy & Immunology Physician
  • Bloomington, IN
National Provider Identifier
1629076849
Registry record updated Oct 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
02001722A Issued in IN
Practice address
485 S Landmark Ave
Bloomington, IN 47403-5005
Phone
(812) 334-1198
Fax
(812) 334-1199
NPI assigned
Jul 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 02001722A IN Primary

Addresses

Primary practice location

485 S Landmark Ave
Bloomington, IN 47403-5005

Mailing address

485 S Landmark Ave
Bloomington, IN 47403-5005
Phone (812) 334-1198

Other identifiers 1

IdentifierTypeStateIssuer
200091640MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20100726000296 IN Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 1052349248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PSF PLLCGroup PAC ID 1557265543, 98 clinicians

Practice addresses (Care Compare)

485 S Landmark Ave
Bloomington, IN 47403-5005
Phone (812) 334-1198

Hospital & facility affiliations

  • Greene County General Hospital Hospital, Linton, IN, CCN 151317
  • Indiana University Health Bloomington Hospital Hospital, Bloomington, IN, CCN 150051
  • Indiana University Health Bedford Hospital Hospital, Bedford, IN, CCN 151328

Merit-based Incentive Payment System (MIPS)

Final score
84.25 of 100Reported as group
Quality
86.03
Promoting interoperability
86
Improvement activities
40
Cost
73.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02001722AINMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
PSF PLLC Allergy & Immunology CurrentSince Aug 16, 2021 Accepting new patients
Allergy & Asthma of Southern Indiana, P.C. Allergy & Immunology Past Accepting new patients
Allergy & Asthma of Southern Indiana, PC Allergy & Immunology Past Accepting new patients
Allergy & Asthma of Southern Indiana, P.C. Allergy & Immunology Past Accepting new patients

Locations

1600 23rd St
Bedford, IN 47421
Phone (812) 275-3331

485 S Landmark Ave
Bloomington, IN 47403
Phone (812) 334-1198

3003 Charlestown Xing
New Albany, IN 47150
Phone (812) 945-5653

Interoperability endpoints

  • Direct secure messaging: mccormack.daniel.001.0140004@aas.meditab.direct-ci.com
  • Direct secure messaging: mccormack.daniel.003.0140004@aas.meditab.direct-ci.com
  • Direct secure messaging: mccormack.daniel.002.0140004@aas.meditab.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350950400000",
    "number": "1629076849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "485 S LANDMARK AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035005",
            "telephone_number": "812-334-1198",
            "fax_number": "812-334-1199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 S LANDMARK AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035005",
            "telephone_number": "812-334-1198",
            "fax_number": "812-334-1199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "DANIEL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2012-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "IN",
            "license": "02001722A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200091640",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.