Individual provider Active NPI

John M Marcin, OD

  • Optometrist
  • Bradenton, FL
National Provider Identifier
1336131002
Registry record updated Jun 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC832 Issued in FL
Practice address
2003 Cortez Rd W
Bradenton, FL 34207-1241
Phone
(941) 756-2020
Fax
(941) 756-4486
NPI assigned
Aug 18, 2005
Last updated
Jun 16, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC832 FL Primary

Addresses

Primary practice location

2003 Cortez Rd W
Bradenton, FL 34207-1241

Mailing address

2003 Cortez Rd W
Bradenton, FL 34207-1241
Phone (941) 756-2020

Other identifiers 1

IdentifierTypeStateIssuer
084042400MedicaidFL

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)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276646400000",
    "number": "1336131002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 CORTEZ RD W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342071241",
            "telephone_number": "941-756-2020",
            "fax_number": "941-756-4486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 CORTEZ RD W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342071241",
            "telephone_number": "941-756-2020",
            "fax_number": "941-756-4486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCIN",
        "first_name": "JOHN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2010-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084042400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2010; 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.