Individual provider Active NPI

Neal Marshall, OD

  • Optometrist
  • Syracuse, NY
National Provider Identifier
1366523003
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV004851-1 Issued in NY
Practice address
4473 E Genesee St
Syracuse, NY 13214-2242
Phone
(315) 446-1210
NPI assigned
Oct 18, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV004851-1 NY Primary

Addresses

Primary practice location

4473 E Genesee St
Syracuse, NY 13214-2242

Mailing address

4473 E Genesee St
Syracuse, NY 13214-2242
Phone (315) 446-1210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20041110000801 NY Practitioner - Optometry 9830152826 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5775 Bridge St
Suite C
East Syracuse, NY 13057-2955
Phone (315) 446-1210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV004851-1NYMDOptometrist
004851NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Poulin Eyecare Inc. Optometrist CurrentSince Dec 14, 2025 Accepting new patients
Poulin Optometric Eyecare , PLLC Optometrist CurrentSince Dec 14, 2025 Accepting new patients

Locations

94 Main St
Camden, NY 13316
Phone (315) 245-2443

5775 Bridge St
Ste C
East Syracuse, NY 13057
Phone (315) 446-1210

Organizations & group practices 3

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366523003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4473 E GENESEE ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132142242",
            "telephone_number": "315-446-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4473 E GENESEE ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132142242",
            "telephone_number": "315-446-1210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "NEAL",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV004851-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.