Individual provider Active NPI

Danijel Josip Pericic, MD

  • Ophthalmology Physician
  • Philadelphia, PA
National Provider Identifier
1871055095
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD481172 Issued in PA
Practice address
840 Walnut St Ste 930
Philadelphia, PA 19107-5109
Phone
(215) 928-3130
Fax
(215) 592-1923
NPI assigned
Apr 5, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuro-ophthalmology Physician 207WX0109X MD481172 PA
Ophthalmology Physician 207W00000X MD481172 PA Primary

Addresses

Primary practice location

840 Walnut St Ste 930
Philadelphia, PA 19107-5109

Mailing address

840 Walnut St
Philadelphia, PA 19107-5109
Phone (215) 440-3160

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230601001433 PA Practitioner - Ophthalmology 7315273174 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Cooper Medical School of Rowan University, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wills Eye Ophthalmology Clinic, IncGroup PAC ID 9133025166, 146 clinicians

Practice addresses (Care Compare)

840 Walnut St
Philadelphia, PA 19107-5109
Phone (215) 928-3041

Hospital & facility affiliations

  • Wills Eye Hospital Hospital, Philadelphia, PA, CCN 390331
  • Riddle Memorial Hospital Hospital, Media, PA, CCN 390222

Merit-based Incentive Payment System (MIPS)

Final score
87.34 of 100Reported as group
Quality
80.85
Promoting interoperability
100
Improvement activities
40
Cost
76.95

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery73

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD481172PAMDNeuro-ophthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wills Eye Ophthalmology Clinic, Inc Ophthalmology CurrentSince Jul 1, 2023 Accepting new patients

Locations

840 Walnut St
Ste 1230
Philadelphia, PA 19107
Phone (215) 440-3160

840 Walnut St
Philadelphia, PA 19107
Phone (215) 440-3150

840 Walnut St
Ste 930
Philadelphia, PA 19107

Interoperability endpoints

  • Direct secure messaging: danijel.pericic.p1@direct.willseye.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1871055095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 WALNUT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075109",
            "telephone_number": "215-440-3160",
            "fax_number": "215-928-3465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 WALNUT ST STE 930",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075109",
            "telephone_number": "215-928-3130",
            "fax_number": "215-592-1923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERICIC",
        "first_name": "DANIJEL",
        "middle_name": "JOSIP",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-05",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0109X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Neuro-ophthalmology",
            "state": "PA",
            "license": "MD481172",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD481172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.