Individual provider Active NPI

Monika Agnieszka Marczak, O.D.

  • Corneal and Contact Management Optometrist
  • McMurray, PA
National Provider Identifier
1104041508
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
OEG001269 Issued in PA
Practice address
4007 Washington Rd
Donaldson'S Crossroads
McMurray, PA 15317-2520
Phone
(724) 941-5100
NPI assigned
Apr 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X OEG001269 PA Primary

Addresses

Primary practice location

4007 Washington Rd
Donaldson'S Crossroads
McMurray, PA 15317-2520

Mailing address

1761 Moynelle Dr
Pittsburgh, PA 15243-1635
Phone (412) 805-1676

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20040212000051 PA Practitioner - Optometry 0941194765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3923 Washington Rd
MC Murray, PA 15317-2532

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG001269PAMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sharon C. O'Rourke, O.D. LLC PastSince Jun 6, 2022 Accepting new patients
Eagle Eyes Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104041508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1761 MOYNELLE DR",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152431635",
            "telephone_number": "412-805-1676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4007 WASHINGTON RD",
            "address_2": "DONALDSON'S CROSSROADS",
            "city": "MCMURRAY",
            "state": "PA",
            "postal_code": "153172520",
            "telephone_number": "724-941-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCZAK",
        "first_name": "MONIKA",
        "middle_name": "AGNIESZKA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "PA",
            "license": "OEG001269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McMurray, PA

Sources for this page

Verify at the official NPI Registry.