Individual provider Active NPI

Marcia J Monroe, O.D.

  • Optometrist
  • Seymour, IN
National Provider Identifier
1073637815
Registry record updated Nov 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18002155B Issued in IN
Practice address
915 W Brown St
Seymour, IN 47274-2715
Phone
(812) 522-8777
Fax
(812) 524-0042
NPI assigned
Mar 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2019

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18002155B IN Primary
Occupational Vision Optometrist 152WX0102X 18002155B IN
Corneal and Contact Management Optometrist 152WC0802X 18002155A IN
Pediatric Optometrist 152WP0200X 18002155B IN
Sports Vision Optometrist 152WS0006X 18002155A IN
Vision Therapy Optometrist 152WV0400X 18002155B IN

Addresses

Primary practice location

915 W Brown St
Seymour, IN 47274-2715

Mailing address

915 W Brown St
Seymour, IN 47274-2715
Phone (812) 525-5227

Other identifiers 2

IdentifierTypeStateIssuer
100232590MedicaidIN
200390280OtherINGROUP MEDICAID NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20100303001000 IN Practitioner - Optometry 0244375194 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

915 W Brown St
Seymour, IN 47274-2715
Phone (812) 522-8777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18002155BINMDPediatric Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Marcia J. Monroe,O.D.,Inc Optometrist CurrentSince Jul 5, 2002 Accepting new patients
Klaas Medical PastSince Nov 10, 2019 Accepting new patients

Locations

114 Executive Dr
Ste C
Lafayette, IN 47905
Phone (765) 442-1775

915 W Brown St
Seymour, IN 47274
Phone (317) 692-1249

Organizations & group practices 2

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": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573171200000",
    "number": "1073637815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 W BROWN ST",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472742715",
            "telephone_number": "812-525-5227",
            "fax_number": "812-524-0042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 W BROWN ST",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472742715",
            "telephone_number": "812-522-8777",
            "fax_number": "812-524-0042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONROE",
        "first_name": "MARCIA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2019-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002155B",
            "primary": true
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "IN",
            "license": "18002155B",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "IN",
            "license": "18002155A",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "IN",
            "license": "18002155B",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "IN",
            "license": "18002155A",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "IN",
            "license": "18002155B",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100232590",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID NUMBER",
            "identifier": "200390280",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seymour, IN

Sources for this page

Verify at the official NPI Registry.