Individual provider Active NPI

Cassidy Marino

  • Optometrist
  • Lewis Center, OH
National Provider Identifier
1023704590
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.007151 Issued in OH
Practice address
6456 Pullman Dr
Lewis Center, OH 43035-7377
Phone
(740) 548-0100
NPI assigned
Apr 17, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X OPT.007151 OH Primary

Addresses

Primary practice location

6456 Pullman Dr
Lewis Center, OH 43035-7377

Mailing address

2623 Open Bay CT
Galena, OH 43021-9061

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20230810001597 OH Practitioner - Optometry 8729440516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optimal Eye Care LLCGroup PAC ID 7517151673, 2 clinicians

Practice addresses (Care Compare)

6456 Pullman Dr
Lewis Center, OH 43035-7377
Phone (740) 548-0100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Optimal Eye Care LLC Optometrist CurrentSince May 30, 2023 Accepting new patients

Locations

6456 Pullman Dr
Lewis Center, OH 43035
Phone (740) 548-0100

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1681689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1023704590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2623 OPEN BAY CT",
            "city": "GALENA",
            "state": "OH",
            "postal_code": "430219061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6456 PULLMAN DR",
            "city": "LEWIS CENTER",
            "state": "OH",
            "postal_code": "430357377",
            "telephone_number": "740-548-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINO",
        "first_name": "CASSIDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-17",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.007151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewis Center, OH

Sources for this page

Verify at the official NPI Registry.