Organization Active NPI

Cassie Mark LLC

  • Optometrist
  • Newton, MA
National Provider Identifier
1497255236
Registry record updated Apr 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5229 Issued in MA
Legal business name
CASSIE MARK LLC
Practice address
42 Langley Rd
Newton, MA 02459-1918
Phone
(617) 869-8464
NPI assigned
Feb 19, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2019

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

Authorized official

Name
Dr. Cassandra L Mark, ODNPI 1487182010
Title
Optometrist
Phone
(617) 431-5747

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 5229 MA Primary

Addresses

Primary practice location

42 Langley Rd
Newton, MA 02459-1918

Mailing address

42 Langley Rd
Newton, MA 02459-1918
Phone (617) 431-5747

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200414000108 MA Part B Supplier - Clinic/Group Practice 0143650275 Receives reassigned benefits from 1 practitioner
Practice locations: Newton, MA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1518998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555632000000",
    "number": "1497255236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 LANGLEY RD",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024591918",
            "telephone_number": "617-431-5747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 LANGLEY RD",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024591918",
            "telephone_number": "617-869-8464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASSIE MARK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-19",
        "last_updated": "2019-04-19",
        "status": "A",
        "authorized_official_last_name": "MARK",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "617-431-5747",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2019; 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.