DANIEL P. ETHAKOTI (OD) – Optometrist, NPI 1740662964

DANIEL P. ETHAKOTI (OD) is a healthcare provider. based in Alton, Illinois. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 2015020209 (MO). The NPI Number for DANIEL P. ETHAKOTI (OD) is 1740662964

Main info

Male
11 Years Of Experience
Accepts Medicare Assignment
Name
DANIEL P. ETHAKOTI (OD)
NPI
1740662964
Phone
(618) 462-9818
Address
211 E BROADWAY
Enumeration Date
24 June 2015
Last Update Date
24 June 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3149970002
Graduation Year
2015 (11 years ago)
PAC ID
9032422738
Professional Enrollment ID
I20150724010090
Address ID
MO631241503SA9717XRDXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

863 OPTOMETRY in MO

Provider Addresses for DANIEL P. ETHAKOTI (OD)

  • 211 E BROADWAY

    ALTON, IL 620026220

    Phone: (618) 462-9818

    Fax: (800) 432-6004

    Type: Mailing

  • 3732 S KINGSHIGHWAY BLVD

    SAINT LOUIS, MO 631091800

    Phone: (314) 446-1134

    Fax: (314) 446-1136

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 11 Open Payments records for all available years, with a total value of $190.

Total Amount is formed as General ($190) + Research ($0) + Ownership ($0) = $190.

Last reported payment date: 2024-12-17 • Largest payer in this snapshot: CooperVision Inc. ($87).

Total Amount

$190

General + Research + Ownership

Payments

11

Total payment records

General Amount

$190

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-17

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-07-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20150724010090IOptometryMOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92014Established patient complete exam of visual system1717$0
99213Established patient office or other outpatient visit, 20-29 minutes1414$0
View full utilization report →

Insurance plans in this area (ZIP 62002)

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Reviews

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Frequently asked questions

Can I cross-check DANIEL P. ETHAKOTI (OD) using NPI 1740662964?
NPI 1740662964 belongs to DANIEL P. ETHAKOTI (OD); compare other details if you need extra assurance.
Would DANIEL P. ETHAKOTI (OD) appear as active to a payer?
You can treat DANIEL P. ETHAKOTI (OD) as active for directory purposes; confirm clinical privileges separately.
How would a patient describe DANIEL P. ETHAKOTI (OD)'s focus?
For DANIEL P. ETHAKOTI (OD), the primary taxonomy reads as Optometrist. Clinical services aligned with this taxonomy classification.
Is DANIEL P. ETHAKOTI (OD) located near Alton?
DANIEL P. ETHAKOTI (OD) currently maps to Alton, Illinois in this extract.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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