Individual provider Active NPI

Marnix E Heersink, MD

  • Ophthalmology Physician
  • Dothan, AL
National Provider Identifier
1598794273
Registry record updated Jun 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
00008277 Issued in AL
Practice address
2800 Ross Clark Circle
Dothan, AL 36301
Phone
(334) 793-2211
Fax
(334) 793-7161
NPI assigned
Jul 3, 2006
Last updated
Jun 21, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 00008277 AL Primary

Addresses

Primary practice location

2800 Ross Clark Circle
Dothan, AL 36301

Mailing address

2800 Ross Clark Circle
Dothan, AL 36301
Phone (334) 793-2211

Other identifiers 1

IdentifierTypeStateIssuer
000046558MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040505001391 FL Practitioner - Ophthalmology 8729076831 Reassigns benefits to 1 organization
I20111103000659 AL Practitioner - Ophthalmology 8729076831 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Partners PCGroup PAC ID 8123016334, 31 clinicians

Practice addresses (Care Compare)

2401 State Ave
Panama City, FL 32405-3940
Phone (850) 747-1818

2800 Ross Clark Cir
Dothan, AL 36301-2040
Phone (334) 793-2211

Merit-based Incentive Payment System (MIPS)

Final score
84.59 of 100Reported as group
Quality
87.13
Promoting interoperability
95
Improvement activities
40
Cost
65.66

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery103

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00008277ALMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Surgery Center of Albany, LLC Current Accepting new patients
Eye Partners PC CurrentSince Sep 13, 1999 Accepting new patients
Eye Surgery Center of Albany, LLC Current Accepting new patients
Eye Partners PC Ophthalmology CurrentSince Sep 17, 1999 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
Crescent City Surgery Center LLC PastSince Apr 30, 2003 Accepting new patients

Locations

16685 US Highway 84
Andalusia, AL 36421
Phone (334) 222-7281

2800 Ross Clark Cir
Dothan, AL 36301
Phone (334) 793-3411

2800 Ross Clark Cir
Ste 1
Dothan, AL 36301

151 Regions Way
#1
Destin, FL 32541
Phone (850) 650-6550

4340 Lafayette St
Marianna, FL 32446
Phone (850) 482-2336

2401 State Ave
Panama City, FL 32405
Phone (850) 747-1818

Interoperability endpoints

  • Direct secure messaging: marnix.heersink.p1@direct.ecs.nextgenshare.com

Organizations & group practices 6

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308614400000",
    "number": "1598794273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 ROSS CLARK CIRCLE",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "36301",
            "telephone_number": "334-793-2211",
            "fax_number": "334-793-7161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 ROSS CLARK CIRCLE",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "36301",
            "telephone_number": "334-793-2211",
            "fax_number": "334-793-7161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEERSINK",
        "first_name": "MARNIX",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2011-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AL",
            "license": "00008277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000046558",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.