Daniel L Peters, O.D.
Individual provider Active NPI Optometrist · Winner, SD
NPI 1730131392 · NPPES record last updated Oct 23, 2013
Key facts
- NPI
- 1730131392
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 110 (SD)
- Practice address
- 1436 E 10TH St
Winner, SD 57580-2818 - Phone
- (605) 842-1974
- Fax
- (605) 842-2328
- NPI assigned
- May 16, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Illinois College of Optometry at Chicago, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Haley Optical LLC
Practice addresses (Care Compare)
1436 E 10TH St
Suite 1
Winner, SD 57580-2874
Phone (605) 842-1974
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040826001322 | SD | Practitioner - Optometry | 1850366568 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110 | SD | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Haley Optical LLC | Optometrist | Current |
Accepting new patients |
Locations
1436 E 10th St
Ste 1
Winner, SD 57580
Phone (605) 328-9200
1436 E 10th St
Winner, SD 57580
Phone (605) 842-1974
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 110 | SD | Yes |
Addresses
Primary practice location
1436 E 10TH St
Winner, SD 57580-2818
Mailing address
1436 E 10TH St
Winner, SD 57580-2818
Phone (605) 842-1974
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9201632 | Medicaid | SD |
Other providers in Winner, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 23, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.