Organization Active NPI

Marciano Family Vision Associates PA

  • Optometrist
  • Palm Beach Gardens, FL
National Provider Identifier
1114491628
Registry record updated Jan 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MARCIANO FAMILY VISION ASSOCIATES PA
Practice address
11380 Prosperity Farms Rd Ste 120
Palm Beach Gardens, FL 33410-3464
Phone
(561) 627-1114
Fax
(561) 627-2304
NPI assigned
Jan 17, 2019
Last updated
Jan 17, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2019

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

Authorized official

Name
Dr. Brandee Owens Marciano, ODNPI 1184618365
Title
Owner/Optometrist
Phone
(561) 627-1114

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

11380 Prosperity Farms Rd Ste 120
Palm Beach Gardens, FL 33410-3464

Mailing address

11380 Prosperity Farms Rd Ste 120
Palm Beach Gardens, FL 33410-3464
Phone (561) 627-1114

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190412001531 FL Part B Supplier - Clinic/Group Practice 6103167523 Receives reassigned benefits from 5 practitioners
Practice locations: Palm Beach Gardens, FL

National Provider Directory

National Provider Directory

Locations

11380 Prosperity Farms Rd
Ste 120
Palm Beach Gardens, FL 33410
Phone (561) 627-1114

12325 Northlake Blvd
Unit 110
Palm Beach Gardens, FL 33412
Phone (561) 264-2490

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1547683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547683200000",
    "number": "1114491628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11380 PROSPERITY FARMS RD STE 120",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334103464",
            "telephone_number": "561-627-1114",
            "fax_number": "561-627-2304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11380 PROSPERITY FARMS RD STE 120",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334103464",
            "telephone_number": "561-627-1114",
            "fax_number": "561-627-2304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARCIANO FAMILY VISION ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-17",
        "last_updated": "2019-01-17",
        "status": "A",
        "authorized_official_last_name": "MARCIANO",
        "authorized_official_first_name": "BRANDEE",
        "authorized_official_middle_name": "OWENS",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "561-627-1114",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.