Individual provider Active NPI

Michael E Marden, OD

  • Optometrist
  • Rockport, ME
National Provider Identifier
1265532139
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT591 Issued in ME
Practice address
377 Commercial St
Rockport, ME 04856-4403
Phone
(207) 236-8879
Fax
(207) 236-3885
NPI assigned
Sep 22, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT591 ME Primary

Addresses

Primary practice location

377 Commercial St
Rockport, ME 04856-4403

Mailing address

377 Commercial St
Rockport, ME 04856-4403
Phone (207) 236-8879

Other identifiers 2

IdentifierTypeStateIssuer
005978OtherMEANTHEM
MNT161OtherMEHARVARD PILGRIM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20080304000196 ME Practitioner - Optometry 3274502083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1976
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11 Swan Lake Ave
Belfast, ME 04915-7018
Phone (207) 338-1900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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, 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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265532139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "377 COMMERCIAL ST",
            "city": "ROCKPORT",
            "state": "ME",
            "postal_code": "048564403",
            "telephone_number": "207-236-8879",
            "fax_number": "207-236-3885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 COMMERCIAL ST",
            "city": "ROCKPORT",
            "state": "ME",
            "postal_code": "048564403",
            "telephone_number": "207-236-8879",
            "fax_number": "207-236-3885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARDEN",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ME",
            "license": "OPT591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "005978",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "MNT161",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockport, ME

Sources for this page

Verify at the official NPI Registry.