Mark Wayne Keyes, O.D.
Individual provider Active NPI Optometrist · Accomac, VA
NPI 1174546196 · NPPES record last updated Sep 22, 2023
Key facts
- NPI
- 1174546196
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 0618000073 (VA)
- Practice address
- 23079 Courthouse Ave
Accomac, VA 23301-1505 - Phone
- (757) 787-7040
- Fax
- (757) 787-2886
- NPI assigned
- Jul 25, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Pennsylvania College of Optometry, 1984
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Bortnick and Furman, P.C.
Practice addresses (Care Compare)
23079 Courthouse Ave
Accomac, VA 23301-1505
Phone (757) 787-7040
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120113000670 | VA | Practitioner - Optometry | 3870606569 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0618000073 | VA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bortnick & Furman, P.C. | Optometrist | Current |
Accepting new patients |
Locations
23079 Courthouse Ave
#28
Accomac, VA 23301
23079 Courthouse Ave
Accomac, VA 23301
Phone (757) 787-7040
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 0618000073 | VA | Yes |
Addresses
Primary practice location
23079 Courthouse Ave
Accomac, VA 23301-1505
Mailing address
23079 Courthouse Ave
Accomac, VA 23301-1505
Phone (757) 787-7040
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174546196 | Medicaid | VA | |
| 1508048026 | Medicaid | VA |
Other providers in Accomac, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 22, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.