Mark Alan Popp, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC1956 Issued in FL

Practice address

447 Atlantic Blvd
Atlantic Beach, FL 32233-4004

Phone

(904) 247-0211

Fax

(904) 246-6115

NPI assigned

May 15, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Optometry

Education

Southern College of Optometry, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gateway Vision IncGroup PAC ID 8022029222, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Gateway Vision Inc

  • Optometrist
  • Atlantic Beach, FL
  • NPI 1205885886
  Medicare reassignment Care Compare group NPD
• Gateway Vision, Inc

  • Optometrist
  • Jacksonville, FL
  • NPI 1447420443
  NPD (past)

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319500800000",
    "number": "1225089295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "447 ATLANTIC BLVD",
            "city": "ATLANTIC BEACH",
            "state": "FL",
            "postal_code": "322334050",
            "telephone_number": "904-247-0211",
            "fax_number": "904-246-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "447 ATLANTIC BLVD",
            "city": "ATLANTIC BEACH",
            "state": "FL",
            "postal_code": "322334004",
            "telephone_number": "904-247-0211",
            "fax_number": "904-246-6115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPP",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2011-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC1956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078899600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shavonne Orr
• Marilyn E Panganiban, LD/N
• Ryan Parker
• John C Perrotto, D.O.
• Susanne Podzamsky
• Linda Nell Porter, LMT
• Possabilities Plus
• Anastasiia Pustovalova
• Susan Quinn
• Stephanie Ridgeway

• Optometrist in Atlantic Beach, FL
• Providers in Atlantic Beach, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.