Individual provider Active NPI

Daniel P Clare, OD

  • Optometrist
  • Burnsville, MN
National Provider Identifier
1831162098
Registry record updated Oct 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2654 Issued in MN
Practice address
Pearle Vision
1056 Burnsville Center
Burnsville, MN 55306-6301
Phone
(952) 435-8821
Fax
(952) 435-1624
NPI assigned
Feb 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2654 MN Primary

Addresses

Primary practice location

Pearle Vision
1056 Burnsville Center
Burnsville, MN 55306-6301

Mailing address

Pearle Vision
1056 Burnsville Center
Burnsville, MN 55306-6301
Phone (952) 435-8821

Other identifiers 3

IdentifierTypeStateIssuer
6C439CLOtherMNBLUE CROSS BLUE SHIELD MN
918988OtherMNEYE MED / COLE VISION
290205200MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20090209000211 MN Practitioner - Optometry 6608931654 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sirius Vision Optical Inc Optometrist CurrentSince Sep 1, 2024 Accepting new patients
Sirius Vision Optometry PC Optometrist CurrentSince Oct 4, 2016 Accepting new patients
Pearle Vision Inc Past Accepting new patients
Luxottica of America Inc Past Accepting new patients

Locations

1056 Burnsville Ctr
Burnsville, MN 55306
Phone (952) 435-8821

1063 Burnsville Ctr
Burnsville, MN 55306
Phone (952) 435-8821

Organizations & group practices 4

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": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476748800000",
    "number": "1831162098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PEARLE VISION",
            "address_2": "1056 BURNSVILLE CENTER",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553066301",
            "telephone_number": "952-435-8821",
            "fax_number": "952-435-1624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PEARLE VISION",
            "address_2": "1056 BURNSVILLE CENTER",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553066301",
            "telephone_number": "952-435-8821",
            "fax_number": "952-435-1624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARE",
        "first_name": "DANIEL",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2016-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MN",
            "identifier": "6C439CL",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYE MED / COLE VISION",
            "identifier": "918988",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "290205200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnsville, MN

Sources for this page

Verify at the official NPI Registry.