Organization Active NPI

Marineau Eye Care, PLC

  • Optometrist
  • Douglas, MI
National Provider Identifier
1477396901
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MARINEAU EYE CARE, PLC
Practice address
114 Blue Star Hwy
Douglas, MI 49406-5139
Phone
(269) 857-2020
Fax
(269) 857-4099
NPI assigned
Jun 13, 2024
Last updated
May 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Authorized official

Name
Olivia Michelle Marineau, ODNPI 1275159246
Title
Owner/Optometrist
Phone
(269) 857-2020

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
Optometrist 152W00000X Primary

Addresses

Primary practice location

114 Blue Star Hwy
Douglas, MI 49406-5139

Mailing address

PO Box 998
Douglas, MI 49406-0998
Phone (269) 857-2020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240716001368 MI Part B Supplier - Clinic/Group Practice 7315482205 Receives reassigned benefits from 1 practitioner
Practice locations: Douglas, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1718236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747872000000",
    "number": "1477396901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 998",
            "city": "DOUGLAS",
            "state": "MI",
            "postal_code": "494060998",
            "telephone_number": "269-857-2020",
            "fax_number": "269-857-4099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 BLUE STAR HWY",
            "city": "DOUGLAS",
            "state": "MI",
            "postal_code": "494065139",
            "telephone_number": "269-857-2020",
            "fax_number": "269-857-4099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARINEAU EYE CARE, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-13",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A",
        "authorized_official_last_name": "MARINEAU",
        "authorized_official_first_name": "OLIVIA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "269-857-2020",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglas, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; 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.