Mark H Williams, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

7603T Issued in CA

Practice address

239 Avenida del Norte
Redondo Beach, CA 90277-5702

Phone

(310) 540-5545

Fax

(310) 540-5536

NPI assigned

Jan 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Optometry

Education

Southern California College of Optometry, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Riviera Village Optometry PCGroup PAC ID 4880855378, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Riviera Village Optometry PC

  • Optometrist
  • Redondo Beach, CA
  • NPI 1457537946
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360195200000",
    "number": "1316917842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 AVENIDA DEL NORTE",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902775702",
            "telephone_number": "310-540-5545",
            "fax_number": "310-540-5536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 AVENIDA DEL NORTE",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902775702",
            "telephone_number": "310-540-5545",
            "fax_number": "310-540-5536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MARK",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2013-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7603T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William J Wickwire M D Inc a Professional Corporation
• Mercedes Williams-Brown, MS
• Isabella Elena Williams, LMFT, ATR
• Kaegun Williams
• Kristen Kay Williams, M.S.W.
• Dane R Wimmer, MD
• Diane Wing
• Brenna Winkle, MFT
• Christine Winkler, PH.D. MFT
• Randy Jo Winston-Hillier, LMFT

• Optometrist in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.