Organization Active NPI

Mark a Snyder OD LLC

  • Optometrist
  • Indianapolis, IN
National Provider Identifier
1184139594
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MARK A SNYDER OD LLC
Practice address
1035 N Post Rd
Indianapolis, IN 46219-4234
Phone
(317) 449-2122
Fax
(317) 449-2123
NPI assigned
Dec 7, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Authorized official

Name
Dr. Mark A Snyder, ODNPI 1811949530
Title
Owner
Phone
(317) 449-2122

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1035 N Post Rd
Indianapolis, IN 46219-4234

Mailing address

1035 N Post Rd
Indianapolis, IN 46219-4234
Phone (317) 449-2122

Other identifiers 1

IdentifierTypeStateIssuer
300009910MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171214003039 IN Part B Supplier - Clinic/Group Practice 6204194558 Receives reassigned benefits from 2 practitioners
Practice locations: Indianapolis, IN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2141613Mark a Snyder, OD, LLC D/B/a Infinity Eye Care1035 N Post Rd, Ste B, Indianapolis, IN 46219Certificate of waiverDec 17, 2027

National Provider Directory

National Provider Directory

Locations

1035 N Post Rd
Ste B
Indianapolis, IN 46219
Phone (317) 449-2122

1035 N Post Rd
Indianapolis, IN 46219
Phone (317) 449-2122

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1512604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1184139594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 N POST RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194234",
            "telephone_number": "317-449-2122",
            "fax_number": "317-449-2123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 N POST RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194234",
            "telephone_number": "317-449-2122",
            "fax_number": "317-449-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK A SNYDER OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-07",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "SNYDER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-449-2122",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300009910",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.