Individual provider Active NPI

Richard Hugh Marcus, O.D,

  • Optometrist
  • Alameda, CA
National Provider Identifier
1396804050
Registry record updated Nov 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6738T Issued in CA
Practice address
512 Westline Dr
Suite 104
Alameda, CA 94501-7649
Phone
(510) 523-6339
NPI assigned
Dec 8, 2006
Last updated
Nov 22, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 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 6738T CA Primary

Addresses

Primary practice location

512 Westline Dr
Suite 104
Alameda, CA 94501-7649

Mailing address

512 Westline Dr
Suite 104
Alameda, CA 94501-7649
Phone (510) 523-6339

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20101020001447 CA Practitioner - Optometry 9638362874

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6738TCAMDOptometrist

Organizations & group practices 1

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": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290384000000",
    "number": "1396804050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 WESTLINE DR",
            "address_2": "SUITE 104",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945017649",
            "telephone_number": "510-523-6339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 WESTLINE DR",
            "address_2": "SUITE 104",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945017649",
            "telephone_number": "510-523-6339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCUS",
        "first_name": "RICHARD",
        "middle_name": "HUGH",
        "name_prefix": "Dr.",
        "credential": "O.D,",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2010-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "6738T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alameda, CA

Sources for this page

Verify at the official NPI Registry.