Individual provider Active NPI

Mark Leonard Schluter, M.D.

  • Ophthalmology Physician
  • Sonoma, CA
National Provider Identifier
1275581126
Registry record updated Nov 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G87496 Issued in CA
Practice address
696 3Rd St W
Sonoma, CA 95476-6805
Phone
(707) 996-1900
Fax
(707) 996-4396
NPI assigned
May 4, 2006
Last updated
Nov 30, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X G87496 CA Primary

Addresses

Primary practice location

696 3Rd St W
Sonoma, CA 95476-6805

Mailing address

696 3Rd St W
Sonoma, CA 95476-6805
Phone (707) 996-1900

Other identifiers 1

IdentifierTypeStateIssuer
00G874960MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G87496CAMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196380800000",
    "number": "1275581126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "696 3RD ST W",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954766805",
            "telephone_number": "707-996-1900",
            "fax_number": "707-996-4396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "696 3RD ST W",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954766805",
            "telephone_number": "707-996-1900",
            "fax_number": "707-996-4396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLUTER",
        "first_name": "MARK",
        "middle_name": "LEONARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2007-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G87496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G874960",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sonoma, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.