Mark E. Schmidt OD
Organization Active NPI Eyewear Supplier · Brookville, OH
NPI 1255500765 · NPPES record last updated Mar 31, 2008
Key facts
- NPI
- 1255500765
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Eyewear Supplier 332H00000X
- License
- 4047 (OH)
- Legal business name
- MARK E. SCHMIDT OD
- Practice address
- 460 Rona Pkwy
Brookville, OH 45309-1118 - Phone
- (937) 833-4054
- Fax
- (937) 833-4055
- NPI assigned
- Feb 28, 2008
- Organization subpart
- No
Authorized official
- Name
- Dr. Mark Everett Schmidt, O.D.
- Title
- Owner
- Phone
- (937) 833-4054
Practitioners 1
-
Mark Everett Schmidt, O.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D2061071 | Mark E Schmidt OD | Certificate of waiver | Jun 20, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Mark E Schmidt OD |
Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930010099 | OH | DME Supplier - Physician - Optometrist | 3870610199 | Practice locations: Brookville, OH |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Eyewear Supplier | 332H00000X | 4047 | OH | Yes |
Addresses
Primary practice location
460 Rona Pkwy
Brookville, OH 45309-1118
Mailing address
460 Rona Pkwy
Brookville, OH 45309-1118
Phone (937) 833-4054
Other providers in Brookville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 31, 2008. 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.
- 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.