Dale S Johnson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC 2675 Issued in FL

Practice address

983 W State Road 434
Longwood, FL 32750-5103

Phone

(407) 261-0505

Fax

(407) 831-4936

NPI assigned

Jul 22, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dale S Johnson OD PA

  dba EyeCare of Longwood

  • Optometrist
  • Longwood, FL
  • NPI 1427177039
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369008000000",
    "number": "1730344433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "983 W STATE ROAD 434",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327505103",
            "telephone_number": "407-261-0505",
            "fax_number": "407-831-4936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "983 W STATE ROAD 434",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327505103",
            "telephone_number": "407-261-0505",
            "fax_number": "407-831-4936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DALE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-22",
        "last_updated": "2013-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 2675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMIER EYECARE",
            "identifier": "65054",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "621271900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joan Z Cornier LLC
• John R Thibodeau LLC
• Acoya Johnson
• Alaina Johnson
• Brookcalleda Deeperlina Johnson
• Melody Marie Johnson, PA-C
• Nancy C Johnston, MS, CCC-SLP
• Jon D Wiese MD Facs PA
• Emily Jones
• Maylynn Jones, MSW

• Optometrist in Longwood, FL
• Providers in Longwood, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.