Individual provider Active NPI

Daniel Mottola, O.D

  • Optometrist
  • Wilmington, NC
National Provider Identifier
1770524100
Registry record updated Feb 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0985 Issued in NC
Practice address
4908 Wrightsville Ave
Wilmington, NC 28403-5257
Phone
(910) 791-2755
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0985 NC Primary

Addresses

Primary practice location

4908 Wrightsville Ave
Wilmington, NC 28403-5257

Mailing address

4908 Wrightsville Ave
Wilmington, NC 28403-5257
Phone (910) 791-2755

Other identifiers 3

IdentifierTypeStateIssuer
152W00000XMedicaidNC
8909641MedicaidNC
1770524100OtherNCNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20120106000718 NC Practitioner - Optometry 2062688385 Practice locations: Wilmington, NC

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4908 Wrightsville Ave
Wilmington, NC 28403-5257
Phone (910) 791-2755

4908 Wrightsville Ave
Wilmington, NC 28403-5287

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
985NCMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550016000000",
    "number": "1770524100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4908 WRIGHTSVILLE AVE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035257",
            "telephone_number": "910-791-2755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4908 WRIGHTSVILLE AVE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035257",
            "telephone_number": "910-791-2755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTTOLA",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2019-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "0985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152W00000X",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8909641",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1770524100",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.