Individual provider Active NPI

Danielle Staresinic, OD

  • Optometrist
  • Pittsburgh, PA
National Provider Identifier
1790777498
Registry record updated Jul 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000851 Issued in PA
Practice address
4122 Butler St
Pittsburgh, PA 15201-3162
Phone
(412) 682-2339
Fax
(412) 682-2809
NPI assigned
Aug 18, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG000851 PA Primary

Addresses

Primary practice location

4122 Butler St
Pittsburgh, PA 15201-3162

Mailing address

4122 Butler St
Pittsburgh, PA 15201-3162
Phone (412) 682-2339

Other identifiers 2

IdentifierTypeStateIssuer
0019235370002MedicaidPA
058539OtherOHMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20101015001115 PA Practitioner - Optometry 2567655061 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dormont Vision Center LLCGroup PAC ID 7719202340, 3 clinicians

Practice addresses (Care Compare)

2893 W Liberty Ave
Pittsburgh, PA 15216-2619
Phone (412) 344-8534

4321 Butler St
Pittsburgh, PA 15201-3009
Phone (412) 682-2339

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dormont Vision Center LLC Optometrist CurrentSince Oct 7, 2014 Accepting new patients
Lawrenceville Vision Care, P.C. Optometrist CurrentSince Oct 18, 2001 Accepting new patients
Ophthalmology Consultants, PC Past Accepting new patients

Locations

2893 W Liberty Ave
Pittsburgh, PA 15216
Phone (412) 344-8534

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15086/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247788800000",
    "number": "1790777498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4122 BUTLER ST",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152013162",
            "telephone_number": "412-682-2339",
            "fax_number": "412-382-2809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4122 BUTLER ST",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152013162",
            "telephone_number": "412-682-2339",
            "fax_number": "412-682-2809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARESINIC",
        "first_name": "DANIELLE",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-18",
        "last_updated": "2009-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019235370002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "058539",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.