Individual provider Active NPI

Daniel Benjamin Myers, O.D.

  • Optometrist
  • Winnetka, IL
National Provider Identifier
1639431000
Registry record updated May 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3289 Issued in MN
Practice address
910 Green Bay Rd
Winnetka, IL 60093-1719
Phone
(636) 399-5826
NPI assigned
Jun 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3289 MN Primary

Addresses

Primary practice location

910 Green Bay Rd
Winnetka, IL 60093-1719

Mailing address

910 Green Bay Rd
Winnetka, IL 60093-1719
Phone (636) 399-5826

Other practice location 1

1790 Lexington Ave N
Roseville, MN 55113-6167
Phone (651) 488-6771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, NY, MO3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20220810003770 IL Practitioner - Optometry 7719139419 Reassigns benefits to 2 organizations
I20240306002104 NY Practitioner - Optometry 7719139419 Reassigns benefits to 1 organization
I20240309000669 MO Practitioner - Optometry 7719139419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

910 Green Bay Rd
Winnetka, IL 60093-1719
Phone (847) 386-9045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009728NYMDNutritionist

Practice roles

OrganizationSpecialtyStatusNew patients
Visionworks, Inc CurrentSince Mar 1, 2024 Accepting new patients
Empire Vision Center, Inc CurrentSince Feb 1, 2024 Accepting new patients
Visionworks, Inc. Optometrist CurrentSince Mar 1, 2024 Accepting new patients
Empire Vision Center Inc Optometrist CurrentSince Feb 1, 2024 Accepting new patients
Visionworks, Inc. Optometrist CurrentSince Apr 14, 2024 Accepting new patients

Locations

239 Golf Mill Ctr
Ste 255
Niles, IL 60714
Phone (847) 297-2286

2422 US Highway 34
Oswego, IL 60543
Phone (630) 551-4133

2825 S Glenstone Ave
Ste F11
Springfield, MO 65804
Phone (417) 882-3692

2680 Delaware Ave
Ste C
Buffalo, NY 14216
Phone (716) 873-1241

560 Troy Schenectady Rd
#7
Latham, NY 12110
Phone (518) 783-0090

1930 South Rd
#105
Poughkeepsie, NY 12601
Phone (845) 298-3200

2590 W Ridge Rd
Rochester, NY 14626
Phone (585) 227-7150

2921 Erie Blvd E
Syracuse, NY 13224
Phone (315) 446-3145

Organizations & group practices 6

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": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652313600000",
    "number": "1639431000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 GREEN BAY RD",
            "city": "WINNETKA",
            "state": "IL",
            "postal_code": "600931719",
            "telephone_number": "636-399-5826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 GREEN BAY RD",
            "city": "WINNETKA",
            "state": "IL",
            "postal_code": "600931719",
            "telephone_number": "636-399-5826"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1790 Lexington Ave N",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "MN",
            "postal_code": "551136167",
            "country_code": "US",
            "telephone_number": "651-488-6771",
            "fax_number": "651-488-5576",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYERS",
        "first_name": "DANIEL",
        "middle_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-12",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winnetka, IL

Sources for this page

Verify at the official NPI Registry.