Individual provider Active NPI

Marina L. Gurvich, O.D.

  • Optometrist
  • Suwanee, GA
National Provider Identifier
1275819849
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
002607 Issued in GA
Practice address
991 Peachtree Industrial Blvd Ste 114
Suwanee, GA 30024-4343
Phone
(770) 904-0883
Fax
(678) 765-0976
NPI assigned
Oct 27, 2011
Last updated
Jan 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 002607 GA Primary

Addresses

Primary practice location

991 Peachtree Industrial Blvd Ste 114
Suwanee, GA 30024-4343

Mailing address

991 Peachtree Industrial Blvd Ste 114
Suwanee, GA 30024-4343
Phone (770) 904-0883

Other names 1

  • Dr. Marina L. Gorenshteyn Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20121109000202 GA Practitioner - Optometry 7810148301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

991 Peachtree Industrial Blvd
Suite 114
Suwanee, GA 30024-4343
Phone (770) 904-0883

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002607GAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
B.Spectacled-Suwanee Optometrist CurrentSince Mar 4, 2019 Accepting new patients
Eyez, Inc. PastSince Mar 4, 2019 Accepting new patients

Locations

991 Peachtree Industrial Blvd
Ste 114
Suwanee, GA 30024
Phone (770) 904-0883

Organizations & group practices 2

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": "1319673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1275819849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "991 PEACHTREE INDUSTRIAL BLVD STE 114",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300244343",
            "telephone_number": "770-904-0883",
            "fax_number": "678-765-0976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "991 PEACHTREE INDUSTRIAL BLVD STE 114",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300244343",
            "telephone_number": "770-904-0883",
            "fax_number": "678-765-0976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURVICH",
        "first_name": "MARINA",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-27",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "002607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARINA",
            "last_name": "GORENSHTEYN",
            "middle_name": "L.",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Suwanee, GA

Sources for this page

Verify at the official NPI Registry.