Individual provider Active NPI

Marianne Florendo, OD

  • Optometrist
  • South San Francisco, CA
National Provider Identifier
1447667621
Registry record updated Jul 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
15066 Issued in CA
Practice address
1121 El Camino Real
South San Francisco, CA 94080-3207
Phone
(650) 866-4641
Fax
(650) 866-4643
NPI assigned
Jul 19, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 15066 CA Primary

Addresses

Primary practice location

1121 El Camino Real
South San Francisco, CA 94080-3207

Mailing address

1121 El Camino Real
South San Francisco, CA 94080-3207
Phone (650) 866-4641

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
I20160725000681 CA Practitioner - Optometry 7113210485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Western University of Health Sciences College of Dental Med, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

199 Taylor Blvd
Millbrae, CA 94030-1915
Phone (650) 826-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15066CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Optica Optometry Corporation Optometrist CurrentSince Sep 1, 2017 Accepting new patients

Locations

199 Taylor Blvd
Millbrae, CA 94030
Phone (650) 692-7940

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1405728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405728000000",
    "number": "1447667621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 EL CAMINO REAL",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940803207",
            "telephone_number": "650-866-4641",
            "fax_number": "650-866-4643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 EL CAMINO REAL",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940803207",
            "telephone_number": "650-866-4641",
            "fax_number": "650-866-4643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORENDO",
        "first_name": "MARIANNE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-19",
        "last_updated": "2014-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "15066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South San Francisco, CA

Sources for this page

Verify at the official NPI Registry.