Conley L Marcum Jr., O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

204 Issued in AK

Practice address

2011 Abbott Rd
Anchorage, AK 99507

Phone

(907) 336-4400

Fax

(907) 336-4414

NPI assigned

Sep 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AK

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

Specialty

Optometry

Education

Ohio State University - College of Optometry, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cmarcumod@directaddress.net

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.

• Conley Marcum Jr OD Inc

  • Optometrist
  • Anchorage, AK
  • NPI 1649440538
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346976000000",
    "number": "1487745949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7463 WHITE HAWK DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995074808",
            "telephone_number": "907-333-5305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 ABBOTT RD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99507",
            "telephone_number": "907-336-4400",
            "fax_number": "907-336-4414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCUM",
        "first_name": "CONLEY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2012-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AK",
            "license": "204",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5327  T2236",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLEVISION INSURANCE #",
            "identifier": "204206",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL VISION  (NVA) #",
            "identifier": "360756",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OD0204",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney Marchesani
• Dorothy Christina Siona Marchetti
• Thatiana Marchi Reisig
• Stacey Marchini
• Aide' Rodriguez Marcontell, HS1
• Ericka Marie Marcum
• Stephanie Nicole Marcus, LVN
• Daniel Mardones, MD
• Marek Martynowicz Inc.
• Maura Marek

• Optometrist in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Optometrist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.