Individual provider Active NPI

David L McManis, OD

  • Optometrist
  • Davenport, IA
National Provider Identifier
1710965629
Registry record updated Apr 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
IA1667 Issued in IA
Practice address
4007 E 53Rd St
Eyecare Max
Davenport, IA 52807-3059
Phone
(563) 355-4554
Fax
(563) 355-4975
NPI assigned
Jan 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X IA1667 IA Primary

Addresses

Primary practice location

4007 E 53Rd St
Eyecare Max
Davenport, IA 52807-3059

Mailing address

4007 E 53Rd St
Eyecare Max
Davenport, IA 52807-3059
Phone (563) 355-4554

Other identifiers 2

IdentifierTypeStateIssuer
410026190OtherIARAILROAD MEDICARE
1168617MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20080102000529 IA Practitioner - Optometry 1557255064 Receives reassigned benefits from 1 practitioner
Practice locations: Davenport, IA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
IA1667IAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
American Eyecare PC Optometrist PastSince May 6, 1993 Accepting new patients

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334707200000",
    "number": "1710965629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4007 E 53RD ST",
            "address_2": "EYECARE MAX",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073059",
            "telephone_number": "563-355-4554",
            "fax_number": "563-355-4975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4007 E 53RD ST",
            "address_2": "EYECARE MAX",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073059",
            "telephone_number": "563-355-4554",
            "fax_number": "563-355-4975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMANIS",
        "first_name": "DAVID",
        "middle_name": "L",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2012-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "IA1667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410026190",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1168617",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

Verify at the official NPI Registry.