Individual provider Active NPI

Daniel Crook, O.D.

  • Optometrist
  • Chandler, AZ
National Provider Identifier
1720075146
Registry record updated May 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1442 Issued in AZ
Practice address
220 N McKemy Ave
Chandler, AZ 85226-2654
Phone
(480) 961-1865
Fax
(480) 961-4605
NPI assigned
Sep 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1442 AZ Primary

Addresses

Primary practice location

220 N McKemy Ave
Chandler, AZ 85226-2654

Mailing address

220 N McKemy Ave
Chandler, AZ 85226-2654
Phone (480) 961-1865

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20050830000793 AZ Practitioner - Optometry 4183655038 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mohave Eye Centers LTD.Group PAC ID 7911985247, 9 clinicians

Practice addresses (Care Compare)

2110 Airway Ave
Kingman, AZ 86409-3652
Phone (928) 753-2106

Merit-based Incentive Payment System (MIPS)

Final score
80.62 of 100Reported as individual
Quality
61.25
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1442AZMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mohave Eye Center, LTD Optometrist CurrentSince Jan 1, 2023 Accepting new patients
Mohave Eye Centers LTD Optometrist CurrentSince Jan 1, 2023 Accepting new patients
Nationwide Optometry P.C. Optometrist Past Accepting new patients
Nationwide Optometry P.C. Optometrist Past Accepting new patients

Locations

2000 Highway 95
Ste 210
Bullhead City, AZ 86442
Phone (702) 474-0200

2110 Airway Ave
Kingman, AZ 86409
Phone (928) 681-1800

Interoperability endpoints

  • Direct secure messaging: daniel.crook@direct.revolutionehr.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399334400000",
    "number": "1720075146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 N MCKEMY AVE",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852262654",
            "telephone_number": "480-961-1865",
            "fax_number": "480-961-4605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 N MCKEMY AVE",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852262654",
            "telephone_number": "480-961-1865",
            "fax_number": "480-961-4605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROOK",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2014-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.