Individual provider Active NPI

Mark D Roemmich, O.D.

  • Optometrist
  • Greer, SC
National Provider Identifier
1265408827
Registry record updated Sep 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
SC1010 Issued in SC
Practice address
15 Wolf Den Dr
Greer, SC 29650-2985
Phone
(864) 630-4631
NPI assigned
Feb 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X SC1010 SC Primary

Addresses

Primary practice location

15 Wolf Den Dr
Greer, SC 29650-2985

Mailing address

205 W Blackstock Rd Ste 150
Spartanburg, SC 29301-3205
Phone (864) 574-8454

Other identifiers 2

IdentifierTypeStateIssuer
1265408827OtherSCNPI
D10101MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20041012001304 SC Practitioner - Optometry 1850351024 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

205 W Blackstock Rd
Suite 150
Spartanburg, SC 29301-3205
Phone (864) 574-8454

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC1010SCMDOptometrist
1010SCMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Roemmich Eyecare LLC Optometrist CurrentSince Jan 22, 2018 Accepting new patients

Locations

205 W Blackstock Rd
Ste 150
Spartanburg, SC 29301
Phone (864) 574-8454

205 W Blackstock Rd
Spartanburg, SC 29301
Phone (864) 587-5370

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285286400000",
    "number": "1265408827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W BLACKSTOCK RD STE 150",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293013205",
            "telephone_number": "864-574-8454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 WOLF DEN DR",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296502985",
            "telephone_number": "864-630-4631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEMMICH",
        "first_name": "MARK",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2010-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "SC1010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1265408827",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D10101",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greer, SC

Sources for this page

Verify at the official NPI Registry.