Active NPI
Hawkeye Clinic of Marcus, PC
- Optometrist
- Marcus, IA
National Provider Identifier
1003320706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- HAWKEYE CLINIC OF MARCUS, PC
- Practice address
- 406 N Main St
Marcus, IA 51035-7719 - Phone
- (712) 943-9400
- NPI assigned
- Nov 17, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Rachel Vandekop
- Title
- Practice Manager
- Phone
- (712) 943-9400
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary |
Addresses
Primary practice location
406 N Main St
Marcus, IA 51035-7719
Mailing address
105 Gaul Dr
Sergeant Bluff, IA 51054-8963
Phone (712) 943-9400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 73787 | Other | IA | BLUE CROSS BLUE SHIELD |
Other names 1
- Marcus Eyecare
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180111000496 | IA | Part B Supplier - Clinic/Group Practice | 8628337078 |
Receives reassigned benefits from 4 practitioners Practice locations: Marcus, IA |
National Provider Directory
National Provider DirectoryLocations
105 Gaul Dr
Sergeant Bluff, IA 51054
Phone (712) 490-4658
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510876800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1580083200000",
"number": "1003320706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 GAUL DR",
"city": "SERGEANT BLUFF",
"state": "IA",
"postal_code": "510548963",
"telephone_number": "712-943-9400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "406 N MAIN ST",
"city": "MARCUS",
"state": "IA",
"postal_code": "510357719",
"telephone_number": "712-943-9400"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HAWKEYE CLINIC OF MARCUS, PC",
"organizational_subpart": "NO",
"enumeration_date": "2017-11-17",
"last_updated": "2020-01-27",
"certification_date": "2020-01-27",
"status": "A",
"authorized_official_last_name": "VANDEKOP",
"authorized_official_first_name": "RACHEL",
"authorized_official_title_or_position": "PRACTICE MANAGER",
"authorized_official_telephone_number": "712-943-9400",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "73787",
"state": "IA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Marcus Eyecare",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Marcus, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.