Individual provider Active NPI

Marcus Cooke, O.D.

  • Optometrist
  • Fayetteville, AR
National Provider Identifier
1093076820
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2723 Issued in OK
Practice address
1100 N College Ave
Eye Clinic
Fayetteville, AR 72703-1944
Phone
(479) 443-4301
Fax
(479) 587-6105
NPI assigned
Jun 7, 2012
Last updated
Jul 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2723 OK Primary
Optometrist 152W00000X 2680 AR

Addresses

Primary practice location

1100 N College Ave
Eye Clinic
Fayetteville, AR 72703-1944

Mailing address

594 E Millsap Rd
Fayetteville, AR 72703-4096
Phone (479) 442-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20160428001331 AR Practitioner - Optometry 9931357878 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Center PAGroup PAC ID 5395713382, 8 clinicians

Practice addresses (Care Compare)

594 E Millsap Rd
Fayetteville, AR 72703-4096
Phone 4794422020107

Merit-based Incentive Payment System (MIPS)

Final score
90.36 of 100Reported as group
Quality
93.44
Improvement activities
40
Cost
76.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2680ARMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Casey Eye Care, Inc. Optometrist CurrentSince Mar 30, 2016 Accepting new patients
Eye Center, PA Optometrist CurrentSince Aug 1, 2023 Accepting new patients
Northeastern State University College of Optometry Optometrist PastSince Jul 1, 2025 Accepting new patients

Locations

406 S Walton Blvd
Bentonville, AR 72712
Phone (479) 271-0301

406 S Walton Blvd
#V
Bentonville, AR 72712
Phone (479) 271-0301

594 E Millsap Rd
Fayetteville, AR 72703
Phone (479) 442-2020

Interoperability endpoints

  • Direct secure messaging: mcooke@eyecenternwa.emadirect.md

Organizations & group practices 3

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": "1339027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1093076820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "594 E MILLSAP RD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034096",
            "telephone_number": "479-442-2020",
            "fax_number": "479-521-3988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N COLLEGE AVE",
            "address_2": "EYE CLINIC",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727031944",
            "telephone_number": "479-443-4301",
            "fax_number": "479-587-6105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKE",
        "first_name": "MARCUS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-07",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2723",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2680",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.