DR. DANIEL R. OBERMARK OPTOMETRY PC
NPI 1205007614
Optometrist in Poplar Bluff, MO
About Dr. Daniel R. Obermark Optometry Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. DANIEL R. OBERMARK OPTOMETRY PC (NPI 1205007614) is a healthcare organization registered as an optometrist in Poplar Bluff, Missouri and active in the NPI registry since March 2008. The organization lists Daniel Robert Obermark, Optometrist, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 5
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Daniel R. Obermark Optometry Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by February 28, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Dr. Daniel R. Obermark Optometry PC, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Dr. Daniel R. Obermark Optometry PC's NPI number?
The NPI number for Dr. Daniel R. Obermark Optometry PC is 1205007614. It was assigned to this organization in the NPPES registry on March 13, 2008.
Where is Dr. Daniel R. Obermark Optometry PC located?
Dr. Daniel R. Obermark Optometry PC is located at 1909 N. Westwood Blvd., Poplar Bluff, MO 63901. The listed phone number is (573) 785-6717.
What is Dr. Daniel R. Obermark Optometry PC's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Dr. Daniel R. Obermark Optometry PC enrolled in Medicare?
Yes. Dr. Daniel R. Obermark Optometry PC is registered in the Medicare PECOS enrollment system.
When is Dr. Daniel R. Obermark Optometry PC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Missouri, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Dr. Daniel R. Obermark Optometry PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Optometry, reassign their Medicare billing to Dr. Daniel R. Obermark Optometry PC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Dr. Daniel R. Obermark Optometry PC accept?
Health plans from Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 3 other insurers list Dr. Daniel R. Obermark Optometry PC 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 Dr. Daniel R. Obermark Optometry PC was last updated on October 25, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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. Daniel R. Obermark Optometry Pc · NPI 1205007614
Optometrist organization in Poplar Bluff, Missouri. Organization record, active in the CMS NPPES registry since March 13, 2008.
## Identity
- **NPI:** 1205007614 (Entity type: Organization)
- **Enumerated:** March 13, 2008
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **Organization subpart:** No
- **Authorized official:** Daniel Obermark, OPTOMETRIST
## Practice location
- **Address:** 1909 N. WESTWOOD BLVD., Poplar Bluff, MO 63901-2807
- **Phone:** (573) 785-6717 · **Fax:** (573) 785-3561
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Non-DME Part B, Missouri, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 2 clinicians (Optometry) reassign Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 25, 2012
- **Other identifiers:** Medicare UPIN U26376 (MO); Medicaid 318104809 (MO); Medicare NSC 6158590001 (MO); and 2 more
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Source: [NPI Profile](https://npiprofile.com/npi/1205007614) · Data from the CMS NPPES public registry.