Individual provider Active NPI

Mario Roman Martinez, OD

  • Optometrist
  • Atlanta, GA
National Provider Identifier
1508531237
Registry record updated Feb 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT003361 Issued in GA
Practice address
870 Inman Village Pkwy NE Ste 3
Atlanta, GA 30307-5523
Phone
(404) 589-0822
Fax
(404) 589-4766
NPI assigned
Aug 13, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT003361 GA Primary

Addresses

Primary practice location

870 Inman Village Pkwy NE Ste 3
Atlanta, GA 30307-5523

Mailing address

870 Inman Village Pkwy NE Ste 3
Atlanta, GA 30307-5523
Phone (404) 589-0822

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20231227000842 GA Practitioner - Optometry 8022468461 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
MRM Eyecare LLC Optometrist CurrentSince Nov 24, 2025 Accepting new patients
Infocus Eye Care, Inc. Optometrist CurrentSince Nov 17, 2023 Accepting new patients
Song Badaracco Eyecare LLC Optometrist Past Accepting new patients

Locations

6700 Douglas Blvd
Ste 1270
Douglasville, GA 30135
Phone (770) 577-4434

Organizations & group practices 3

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": "1628812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771459200000",
    "number": "1508531237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 INMAN VILLAGE PKWY NE STE 3",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303075523",
            "telephone_number": "404-589-0822",
            "fax_number": "404-589-4766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 INMAN VILLAGE PKWY NE STE 3",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303075523",
            "telephone_number": "404-589-0822",
            "fax_number": "404-589-4766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "MARIO",
        "middle_name": "ROMAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-13",
        "last_updated": "2026-02-19",
        "certification_date": "2026-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.