Individual provider Active NPI

Marty Mrachek, O.D.

  • Optometrist
  • Bismarck, ND
National Provider Identifier
1104963099
Registry record updated Feb 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ND602 Issued in ND
Practice address
1300 E Lasalle Dr Ste 2
Bismarck, ND 58503-5716
Phone
(701) 557-1574
Fax
(701) 557-1649
NPI assigned
Jan 31, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ND602 ND Primary

Addresses

Primary practice location

1300 E Lasalle Dr Ste 2
Bismarck, ND 58503-5716

Mailing address

1300 E Lasalle Dr Ste 2
Bismarck, ND 58503-5716
Phone (701) 557-1574

Other practice location 1

537 S 7th St
Bismarck, ND 58504-5859
Phone (701) 255-8490

Other identifiers 1

IdentifierTypeStateIssuer
P00136359OtherNDRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20081009000216 ND Practitioner - Optometry 8123196706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1300 E Lasalle Dr
Suite 2
Bismarck, ND 58503-5716
Phone (701) 557-1574

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ND602NDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Marty J. Mrachek OD LTD Optometrist CurrentSince Aug 1, 2001 Accepting new patients
Prime Eyecare PC Optometrist PastSince Aug 1, 2001 Accepting new patients

Locations

1300 E Lasalle Dr
Ste 2
Bismarck, ND 58503
Phone (701) 557-1574

537 S 7th St
Bismarck, ND 58504
Phone (701) 221-4988

2700 State St
Bismarck, ND 58503
Phone (701) 221-9152

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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771545600000",
    "number": "1104963099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 E LASALLE DR STE 2",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585035716",
            "telephone_number": "701-557-1574",
            "fax_number": "701-557-1649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 E LASALLE DR STE 2",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585035716",
            "telephone_number": "701-557-1574",
            "fax_number": "701-557-1649"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "537 S 7th St",
            "address_purpose": "LOCATION",
            "city": "Bismarck",
            "state": "ND",
            "postal_code": "585045859",
            "country_code": "US",
            "telephone_number": "701-255-8490",
            "fax_number": "701-255-9349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MRACHEK",
        "first_name": "MARTY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ND",
            "license": "ND602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00136359",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.