Daniel P. Ethakoti, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2015020209 Issued in MO

Practice address

3732 S Kingshighway Blvd
Saint Louis, MO 63109-1800

Phone

(314) 446-1134

Fax

(314) 446-1136

NPI assigned

Jun 24, 2015

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

Medicare fee-for-service enrollment

Enrolled in MO

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

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Overland Optical, Inc.

  • Optician
  • Saint Louis, MO
  • NPI 1457377848
  Medicare reassignment NPD
• Red Eye, Inc.

  • Optometrist
  • Saint Louis, MO
  • NPI 1629257852
  Medicare reassignment NPD
• Ladue Optometry LLC

  • Optometrist
  • Saint Louis, MO
  • NPI 1437010501
  NPD Authorized official
• Overland Optical, Inc

  • Optician
  • Saint Charles, MO
  • NPI 1396833174
  NPD (past)
• Usv Optical Inc

  • Eyewear Supplier
  • St Louis, MO
  • NPI 1104848357
  NPD (past)
• Usv Optical Inc.

  • Eyewear Supplier
  • Des Peres, MO
  • NPI 1558373514
  NPD (past)
• Usv Optical Inc

  • Eyewear Supplier
  • Blackwood, NJ
  • NPI 1578891008

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435104000000",
    "number": "1740662964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E BROADWAY",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026220",
            "telephone_number": "618-462-9818",
            "fax_number": "800-432-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3732 S KINGSHIGHWAY BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631091800",
            "telephone_number": "314-446-1134",
            "fax_number": "314-446-1136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHAKOTI",
        "first_name": "DANIEL",
        "middle_name": "P.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-24",
        "last_updated": "2015-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2015020209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eternal Home Care Services, Inc
• Eternal Love Home Care LLC
• Eternally Loved HC Services LLC
• Eternity Adult Day Care LLC
• Eternity Care, LLC
• Ethan J Schuman DMD
• Ethel Hedgeman Lyle Academy
• Jillian Nicole Ethridge-Brown, MSN, FNP-BC
• Madison Clare Etling, DDS
• Etoya R. White Therapy & Coaching LLC

• Optometrist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2015; 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.