Individual provider Active NPI

Mark Paul Lambrecht, OD

  • Optometrist
  • Beaufort, SC
National Provider Identifier
1447237326
Registry record updated Feb 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2187-035 Issued in WI
Practice address
1 Pinckney Blvd
Beaufort, SC 29902-6148
Phone
(843) 228-5577
Fax
(843) 228-5196
NPI assigned
Dec 30, 2005
Last updated
Feb 22, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X MN2254 MN
Optometrist 152W00000X 2187-035 WI Primary

Addresses

Primary practice location

1 Pinckney Blvd
Beaufort, SC 29902-6148

Mailing address

77 Pepperrell Rd
Box 36
Kittery Point, ME 03905
Phone (207) 439-1452

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20170221001293 TX Practitioner - Optometry 8325322241 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2254MNMDProfessional Counselor
MN2254MNMDOptometrist
2187-035WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
White Earth Indian Health Center CurrentSince Jan 10, 2017 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Apr 10, 2017 Accepting new patients
Pine Point Health Station Current Accepting new patients
Naytahwaush Health Center CurrentSince Jan 10, 2017 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital Current Accepting new patients

Locations

40520 County Highway 34
Ogema, MN 56569
Phone (218) 983-4300

40520 County Highway 34
#C
Ogema, MN 56569
Phone (218) 983-4300

Organizations & group practices 5

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": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456099200000",
    "number": "1447237326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 PEPPERRELL RD",
            "address_2": "BOX 36",
            "city": "KITTERY POINT",
            "state": "ME",
            "postal_code": "03905",
            "telephone_number": "207-439-1452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PINCKNEY BLVD",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299026148",
            "telephone_number": "843-228-5577",
            "fax_number": "843-228-5196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMBRECHT",
        "first_name": "MARK",
        "middle_name": "PAUL",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2016-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "MN2254",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2187-035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaufort, SC

Sources for this page

Verify at the official NPI Registry.