DR. DAVID RAY HAISMAN OD
NPI 1104902923
Optometrist in Spirit Lake, IA
About Dr. David Ray Haisman Od NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. DAVID RAY HAISMAN OD (NPI 1104902923) is an individual optometrist in Spirit Lake, Iowa, licensed in Iowa (002415) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS and is a graduate of Illinois College Of Optometry At Chicago (2003).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. David Ray Haisman Od is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show David Haisman reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Worthington, MN 56187
- Reassigned Medicare billing, Minnesota enrollment
- 260 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 6
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 51360 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 5
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is David Haisman's NPI number?
The NPI number for David Haisman is 1104902923. It was assigned to this individual provider in the NPPES registry on October 27, 2006.
Where is David Haisman located?
David Haisman practices at 2200 17th St, Spirit Lake, IA 51360. The listed phone number is (712) 336-8939.
What is David Haisman's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is David Haisman enrolled in Medicare?
Yes. David Haisman is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for David Haisman's services?
According to the CMS Revalidation Reassignment List (October 2026 release), David Haisman reassigns Medicare benefits to Avera Marshall (Worthington, MN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for David Haisman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does David Haisman accept?
Health plans from Anthem Blue Cross and Blue Shield, Avera Health Plans, Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana and Blue Cross and Blue Shield of Montana and 5 other insurers list David Haisman as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for David Haisman was last updated on June 17, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. David Ray Haisman, OD · NPI 1104902923
Optometrist provider in Spirit Lake, Iowa. Individual provider, active in the CMS NPPES registry since October 27, 2006.
## Identity
- **NPI:** 1104902923 (Entity type: Individual)
- **Enumerated:** October 27, 2006
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **State license:** 002415 (Iowa)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 2200 17TH ST, Spirit Lake, IA 51360
- **Phone:** (712) 336-8939 · **Fax:** (712) 336-8952
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Avera Marshall (NPI 1417378555, Worthington, MN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Illinois College Of Optometry At Chicago, class of 2003
## Record status
- **NPPES last updated:** June 17, 2014
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Source: [NPI Profile](https://npiprofile.com/npi/1104902923) · Data from the CMS NPPES public registry.