Mark Edward Swan, OD MED

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901003186 Issued in MI

Practice address

1124 S State St
Michigan College of Optometry
Big Rapids, MI 49307-2256

Phone

(231) 591-2222

Fax

(231) 591-3991

NPI assigned

Jul 21, 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

Other identifiers 4

Other names 1

• Mark Swan Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Ferris State College - College of Optometry, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ferris State UniversityGroup PAC ID 3971572124, 27 clinicians

Swan Optometry Services PCGroup PAC ID 1456647320, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: drmarkswan@ifrockford.direct.kno2fy.com

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.

• Swan Optometry Services, PC

  • Optometrist
  • Rockford, MI
  • NPI 1124338736
  Medicare reassignment Care Compare group NPD Authorized official
• Ferris State University

  • Optometrist
  • Big Rapids, MI
  • NPI 1871510859
  Medicare reassignment Care Compare group
• Rockford Vision Services, Inc.

  • Prosthetic/Orthotic Supplier
  • Rockford, MI
  • NPI 1760680144
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1386665016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 S STATE ST",
            "address_2": "MICHIGAN COLLEGE OF OPTOMETRY",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493072256",
            "telephone_number": "231-591-2222",
            "fax_number": "231-591-3991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 S STATE ST",
            "address_2": "MICHIGAN COLLEGE OF OPTOMETRY",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493072256",
            "telephone_number": "231-591-2222",
            "fax_number": "231-591-3991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 N Main St",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "MI",
            "postal_code": "493411281",
            "country_code": "US",
            "telephone_number": "616-866-3077",
            "fax_number": "616-866-4408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SWAN",
        "first_name": "MARK",
        "middle_name": "EDWARD",
        "credential": "OD MED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "M5003186",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4401840",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USP",
            "identifier": "999998001",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIORITY HEALTH",
            "identifier": "900006367",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "markswan@ferris.edu",
            "affiliation": "N",
            "endpointDescription": "University Eye Center",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1124 S State St",
            "address_2": "Michigan College of Optometry",
            "city": "Big Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "493072256",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARK",
            "last_name": "SWAN",
            "credential": "OD MED",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kimberly Stevens, PHARMD
• Lynne Dee Stewart, R.N.
• Susan Jean Stewart, LMSW
• Marcie L Stieg-Williams, PAC
• Mary Margaret Stratz
• Stacy Swart
• Sharon K Swedenborg, CRNA
• Mary Kathleen Swier, FNP
• Allison Ann Syrewicze, CPHT
• Teagan Brianne Tarbell, PA-C

• Optometrist in Big Rapids, MI
• Providers in Big Rapids, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; 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.