Individual provider Active NPI

Athanasios George Marneris, D.O

  • Ophthalmology Physician
  • Olympia Fields, IL
National Provider Identifier
1467866228
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
036.150478 Issued in IL
Practice address
20303 Crawford Ave Ste LL
Olympia Fields, IL 60461-1073
Phone
(708) 898-1858
NPI assigned
Jun 19, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 036.150478 IL Primary

Addresses

Primary practice location

20303 Crawford Ave Ste LL
Olympia Fields, IL 60461-1073

Mailing address

20303 Crawford Ave
Ste LL1
Olympia Fields, IL 60461-1173
Phone (616) 252-7800

Other identifiers 1

IdentifierTypeStateIssuer
036.150478MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180711003615 CA Practitioner - Ophthalmology 6608091913 Reassigns benefits to 1 organization
I20191122000451 IL Practitioner - Ophthalmology 6608091913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Mid West Medical College, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multack Eye Care, S.CGroup PAC ID 6507015138, 10 clinicians

Practice addresses (Care Compare)

20303 Crawford Ave
Suite LL1
Olympia Fields, IL 60461-1173
Phone (708) 955-9278

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery236

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036.150478ILMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California SFGH Medical Group CurrentSince Jul 3, 2018 Accepting new patients
University of California SFGH Medical Group Ophthalmology CurrentSince Jul 3, 2018 Accepting new patients
University of California SFGH Medical Group Current Accepting new patients

Locations

1001 Potrero Ave
Rm 3A
San Francisco, CA 94110
Phone (415) 206-4632

Organizations & group practices 4

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": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1467866228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20303 CRAWFORD AVE",
            "address_2": "STE LL1",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611173",
            "telephone_number": "616-252-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20303 CRAWFORD AVE STE LL",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611073",
            "telephone_number": "708-898-1858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARNERIS",
        "first_name": "ATHANASIOS",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-19",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036.150478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036.150478",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia Fields, IL

Sources for this page

Verify at the official NPI Registry.