Individual provider Active NPI

Marko J Hrgovic, OD

  • Optometrist
  • Anchorage, AK
National Provider Identifier
1023168457
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
168 Issued in AK
Practice address
4125 Debarr Rd
Anchorage, AK 99508-3115
Phone
(907) 269-9542
Fax
(907) 269-9541
NPI assigned
Jan 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 168 AK Primary

Addresses

Primary practice location

4125 Debarr Rd
Anchorage, AK 99508-3115

Mailing address

4125 Debarr Rd
Anchorage, AK 99508-3115
Phone (907) 269-9542

Other identifiers 1

IdentifierTypeStateIssuer
OD6943MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20100225000034 AK Practitioner - Optometry 6901940204 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Marko Hrgovic Inc Optometrist CurrentSince Jan 1, 2005 Accepting new patients

Locations

4125 Debarr Rd
Anchorage, AK 99508
Phone (907) 269-9503

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1023168457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4125 DEBARR RD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995083115",
            "telephone_number": "907-269-9542",
            "fax_number": "907-269-9541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4125 DEBARR RD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995083115",
            "telephone_number": "907-269-9542",
            "fax_number": "907-269-9541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HRGOVIC",
        "first_name": "MARKO",
        "middle_name": "J",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AK",
            "license": "168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OD6943",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.