Individual provider Active NPI

Matthew Daniels, O.D.

  • Optometrist
  • Columbia, SC
National Provider Identifier
1962797357
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1597 Issued in SC
Practice address
201 Harbison Blvd
Unit 110
Columbia, SC 29212-2270
Phone
(803) 732-1942
NPI assigned
Jun 14, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1597 SC Primary

Addresses

Primary practice location

201 Harbison Blvd
Unit 110
Columbia, SC 29212-2270

Mailing address

201 Harbison Blvd
Unit 110
Columbia, SC 29212-2270
Phone (803) 732-1942

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20110829000345 SC Practitioner - Optometry 7517137615 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2914 Dreher Shoals Rd
Suite a
Columbia, SC 29212-7909
Phone (803) 233-1774

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1597SCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Martinez Eye Associates LLC Optometrist CurrentSince Aug 12, 2011 Accepting new patients
Eyes on the Lake LLC Optometrist CurrentSince Oct 24, 2017 Accepting new patients

Locations

2914 Dreher Shoals Rd
#A
Columbia, SC 29212
Phone (803) 233-1774

201 Harbison Blvd
Ste 110
Columbia, SC 29212
Phone (803) 732-1917

Organizations & group practices 2

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": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1962797357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 HARBISON BLVD",
            "address_2": "UNIT 110",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292122270",
            "telephone_number": "803-732-1942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 HARBISON BLVD",
            "address_2": "UNIT 110",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292122270",
            "telephone_number": "803-732-1942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-14",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.