Organization Active NPI

Marciano Family Optometric

  • Optometrist
  • West Palm Beach, FL
National Provider Identifier
1447325568
Registry record updated Mar 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 003248 Issued in FL
Legal business name
MARCIANO FAMILY OPTOMETRIC
Practice address
1788 N. Jog Rd.
West Palm Beach, FL 33411-0000
Phone
(561) 242-1200
Fax
(561) 242-1291
NPI assigned
Nov 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2015

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

Authorized official

Name
Dr. Mark Thomas Marciano, O.D.NPI 1528064656
Title
Optometrist-Owner
Phone
(561) 242-1200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPC 003248 FL Primary

Addresses

Primary practice location

1788 N. Jog Rd.
West Palm Beach, FL 33411-0000

Mailing address

1788 N. Jog Rd.
West Palm Beach, FL 33411-0000
Phone (561) 242-1200

Other identifiers 4

IdentifierTypeStateIssuer
5446497OtherFLCIGNA
20844OtherFLBLUE CROSS & BLUE SHIELD
002368580OtherFLUNITED HEALTHCARE
M620930100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040921001165 FL Part B Supplier - Clinic/Group Practice 3577531169 Receives reassigned benefits from 4 practitioners
Practice locations: West Palm Beach, FL

National Provider Directory

National Provider Directory

Locations

1788 N Jog Rd
West Palm Beach, FL 33411
Phone (561) 242-1200

7750 Okeechobee Blvd
Ste 9
West Palm Beach, FL 33411
Phone (561) 242-1200

2021 Palm Beach Lakes Blvd
West Palm Beach, FL 33409
Phone (561) 478-7855

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427414400000",
    "number": "1447325568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1788 N. JOG RD.",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334110000",
            "telephone_number": "561-242-1200",
            "fax_number": "561-242-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1788 N. JOG RD.",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334110000",
            "telephone_number": "561-242-1200",
            "fax_number": "561-242-1291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARCIANO FAMILY OPTOMETRIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2015-03-27",
        "status": "A",
        "authorized_official_last_name": "MARCIANO",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OPTOMETRIST-OWNER",
        "authorized_official_telephone_number": "561-242-1200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 003248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5446497",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "20844",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "002368580",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "M620930100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.