Individual provider Active NPI

Beverly Mark, O.D.

  • Optometrist
  • San Francisco, CA
National Provider Identifier
1578614418
Registry record updated Dec 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8535 Issued in CA
Practice address
3251 20TH Ave Ste 219
San Francisco, CA 94132-1918
Phone
(415) 566-9292
NPI assigned
Jan 16, 2007
Last updated
Dec 6, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8535 CA Primary

Addresses

Primary practice location

3251 20TH Ave Ste 219
San Francisco, CA 94132-1918

Mailing address

2245 Moraga St
San Francisco, CA 94122-4232
Phone (415) 665-2809

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040728000876 CA Practitioner - Optometry 6103896089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total Vision PCGroup PAC ID 9234472242, 115 clinicians

Practice addresses (Care Compare)

5515 Geary Blvd
San Francisco, CA 94121-2208
Phone (415) 387-3553

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8535CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Total Vision PC Optometrist CurrentSince Nov 1, 2021 Accepting new patients
J Pietrantonio OD Inc Optometrist PastSince Jan 1, 2005 Accepting new patients

Locations

5092 Warner Ave
Huntington Beach, CA 92649
Phone (714) 816-4479

233 N Santa Cruz Ave
Los Gatos, CA 95030
Phone (408) 354-9310

27271 Las Ramblas
Ste 210
Mission Viejo, CA 92691

3251 20th Ave
Ste 231
San Francisco, CA 94132
Phone (415) 564-7785

5515 Geary Blvd
San Francisco, CA 94121
Phone (415) 387-3553

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480982400000",
    "number": "1578614418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2245 MORAGA ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941224232",
            "telephone_number": "415-665-2809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3251 20TH AVE STE 219",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941321918",
            "telephone_number": "415-566-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARK",
        "first_name": "BEVERLY",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2016-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.