Individual provider Active NPI

Amy M Marnecheck, O.D.

  • Optometrist
  • Belfast, ME
National Provider Identifier
1104911908
Registry record updated Aug 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT795 Issued in ME
Practice address
91 Waldo Avenue
Belfast, ME 04915
Phone
(207) 338-1480
Fax
(207) 338-1498
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT795 ME Primary

Addresses

Primary practice location

91 Waldo Avenue
Belfast, ME 04915

Mailing address

PO Box 209
Belfast, ME 04915-0209
Phone (207) 338-1480

Other identifiers 2

IdentifierTypeStateIssuer
MM7987OtherMEPTAN#
308220099MedicaidME

Other names 1

  • Dr. Amy M Marnecheck Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20050818000399 ME Practitioner - Optometry 7113957226 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1992
Medicare assignment
May accept Medicare assignment
Group practices
Seebreeze Family Eyecare, P.a.Group PAC ID 0840429791, 2 clinicians

Practice addresses (Care Compare)

91 Waldo Ave
Belfast, ME 04915-6615
Phone (207) 338-1480

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Seebreeze Family Eyecare, P.a. Optometrist CurrentSince Nov 1, 2013 Accepting new patients

Locations

91 Waldo Ave
Waldo, ME 04915
Phone (207) 338-1480

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407974400000",
    "number": "1104911908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 209",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049150209",
            "telephone_number": "207-338-1480",
            "fax_number": "207-338-1498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 WALDO AVENUE",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "04915",
            "telephone_number": "207-338-1480",
            "fax_number": "207-338-1498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARNECHECK",
        "first_name": "AMY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2014-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ME",
            "license": "OPT795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN#",
            "identifier": "MM7987",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "308220099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "MARNECHECK",
            "middle_name": "M",
            "prefix": "DR.",
            "credential": "O.,D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Belfast, ME

Sources for this page

Verify at the official NPI Registry.