Individual provider Active NPI

Mark Schaeffer, O.D.

  • Optometrist
  • Hoover, AL
National Provider Identifier
1194005850
Registry record updated Jun 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S-C77-TA-921 Issued in AL
Practice address
1598 Montgomery Hwy
Hoover, AL 35216-4525
Phone
(205) 979-2020
NPI assigned
Aug 25, 2011
Last updated
Jun 4, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC004618 FL
Optometrist 152W00000X S-C77-TA-921 AL Primary

Addresses

Primary practice location

1598 Montgomery Hwy
Hoover, AL 35216-4525

Mailing address

1598 Montgomery Hwy
Hoover, AL 35216-4525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20120815000306 AL Practitioner - Optometry 5193971703 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Alabama LLCGroup PAC ID 0840559878, 30 clinicians

Practice addresses (Care Compare)

1686 Montgomery Hwy
Vestavia Hills, AL 35216-4906
Phone (205) 900-7351

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S-C77-TA-921ALMDOptometrist
OPC004618FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Alabama, LLC Optometrist CurrentSince Nov 20, 2017 Accepting new patients
Myeyedr Optometry of Alabama LLC Optometrist CurrentSince Nov 20, 2017 Accepting new patients
Myeyedr Optometry of Alabama LLC Optometrist Current Accepting new patients

Locations

3431 Colonnade Pkwy
Ste 100
Birmingham, AL 35243
Phone (205) 967-2020

1686 Montgomery Hwy
Hoover, AL 35216
Phone (205) 900-3746

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1314230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338768000000",
    "number": "1194005850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1598 MONTGOMERY HWY",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352164525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1598 MONTGOMERY HWY",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352164525",
            "telephone_number": "205-979-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAEFFER",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-25",
        "last_updated": "2012-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC004618",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-C77-TA-921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoover, AL

Sources for this page

Verify at the official NPI Registry.