Marc Davis Garden, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

MD02690SE Issued in PA

Practice address

1703 S Broad St
Philadelphia Eye Associates
Philadelphia, PA 19148-1536

Phone

(215) 339-8100

Fax

(215) 339-8103

NPI assigned

Aug 11, 2005

Last updated

Mar 10, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489104000000",
    "number": "1447252333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 S BROAD ST",
            "address_2": "PHILADELPHIA EYE ASSOCIATES",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191481536",
            "telephone_number": "215-339-8100",
            "fax_number": "215-339-8103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 S BROAD ST",
            "address_2": "PHILADELPHIA EYE ASSOCIATES",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191481536",
            "telephone_number": "215-339-8100",
            "fax_number": "215-339-8103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDEN",
        "first_name": "MARC",
        "middle_name": "DAVIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2017-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD02690SE",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "25MA05338400",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "099578",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vanessa Garcia, CRNP
• Dieunie Garcon
• Kevin E Gard, DPT, OCS
• Jeffrey Allan Gardecki, D.O.
• Jamie Gardella, RD
• Gardens of Life Home Health Care Agency LLC
• David F Gardiner, MD
• Diana Deinarowicz Gardiner, CRNP
• Geoffrey A. Gardiner, M.D.
• Margarita Hauser Gardiner, MD

• Ophthalmology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Ophthalmology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.