Individual provider Active NPI

Mark Caruso, O.D.

  • Optometrist
  • Sunrise, FL
National Provider Identifier
1306389739
Registry record updated Dec 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC3097 Issued in FL
Practice address
7730 W Commercial Blvd
Sunrise, FL 33351-4301
Phone
(954) 578-1746
NPI assigned
Dec 3, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC3097 FL Primary

Addresses

Primary practice location

7730 W Commercial Blvd
Sunrise, FL 33351-4301

Mailing address

633 NW 28TH St
Wilton Manors, FL 33311-2462
Phone (954) 295-0404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20190118002509 FL Practitioner - Optometry 7214274802 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC3097FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mark P Caruso, OD, PA Optometrist Past Accepting new patients

Networks

  • Freedom Health HMO Network

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1480723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480723200000",
    "number": "1306389739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 NW 28TH ST",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333112462",
            "telephone_number": "954-295-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7730 W COMMERCIAL BLVD",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333514301",
            "telephone_number": "954-578-1746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARUSO",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-12-03",
        "last_updated": "2016-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

Verify at the official NPI Registry.