Individual provider Active NPI

Daniel L Hayden, O.D.

  • Optometrist
  • Quincy, IL
National Provider Identifier
1821047994
Registry record updated Jan 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046009104 Issued in IL
Practice address
195 S 36TH St
Quincy, IL 62301-5801
Phone
(217) 224-7732
Fax
(217) 214-9437
NPI assigned
May 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046009104 IL Primary

Addresses

Primary practice location

195 S 36TH St
Quincy, IL 62301-5801

Mailing address

195 S 36TH St
Quincy, IL 62301-5801
Phone (217) 224-7732

Other identifiers 5

IdentifierTypeStateIssuer
166876OtherILHEALTHLINK
046009104MedicaidIL
49314OtherILHEALTH ALLIANCE
315345405MedicaidMO
121397OtherILBLUE CROSS/SHIELD OF IL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20100126000018 IL Practitioner - Optometry 0345382644 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Superior Performance Eye Care Services IncGroup PAC ID 4880736180, 2 clinicians

Practice addresses (Care Compare)

195 S 36TH St
Quincy, IL 62301-5801
Phone (217) 224-7732

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 surgery49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046009104ILMDOptometrist

Organizations & group practices 1

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": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262390400000",
    "number": "1821047994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 S 36TH ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623015801",
            "telephone_number": "217-224-7732",
            "fax_number": "217-224-4468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 S 36TH ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623015801",
            "telephone_number": "217-224-7732",
            "fax_number": "217-214-9437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYDEN",
        "first_name": "DANIEL",
        "middle_name": "L",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2010-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "166876",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046009104",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "49314",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "315345405",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/SHIELD OF IL",
            "identifier": "121397",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

Verify at the official NPI Registry.