Individual provider Active NPI

Maricely Gonzalez Macion, O.D.

  • Optometrist
  • Mount Dora, FL
National Provider Identifier
1609084730
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC4140 Issued in FL
Practice address
17560 US Highway 441
Mount Dora, FL 32757-6711
Phone
(352) 744-7002
Fax
(352) 735-3233
NPI assigned
May 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC4140 FL Primary

Addresses

Primary practice location

17560 US Highway 441
Mount Dora, FL 32757-6711

Mailing address

17560 US Highway 441
Mount Dora, FL 32757-6711
Phone (352) 744-7002

Other practice location 1

7101 Fairway Dr
Palm Beach Gardens, FL 33418-3701
Phone (561) 515-1500

Other practice location 2

5743 Williamsburg Ln
Wildwood, FL 34785-8129
Phone (352) 744-7002

Other practice location 3

600 N 14th St
Leesburg, FL 34748-4204
Phone (352) 787-5900

Other practice location 4

17556 SE 109th Terrace Rd
Summerfield, FL 34491-6907
Phone (352) 347-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20080115000610 FL Practitioner - Optometry 7517048648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid Florida Eye Center PAGroup PAC ID 4385678747, 11 clinicians

Practice addresses (Care Compare)

17560 US Hwy 441
Mount Dora, FL 32757-6711
Phone (352) 744-7002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC4140FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mid Florida Eye Center PA Optometrist CurrentSince May 1, 2023 Accepting new patients
Mid Florida Eye Center PA Optometrist CurrentSince May 1, 2023 Accepting new patients
Delray Eye Associates PA Optometrist Current Accepting new patients
Eye Surgery Associates LLC Past Accepting new patients
University of Miami Past Accepting new patients

Locations

600 N 14th St
Leesburg, FL 34748
Phone (352) 744-7002

17560 US Highway 441
Mount Dora, FL 32757
Phone (352) 735-7855

17556 SE 109th Terrace Rd
Summerfield, FL 34491
Phone (352) 347-2100

5743 Williamsburg Ln
Wildwood, FL 34785
Phone (352) 735-2021

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: drmacion@midfloridaeye.ecldirect.net
  • Direct secure messaging: maricely.macion.p4@direct.drea.nextgenshare.com
  • Direct secure messaging: mmacion@espflorida.intellechartdirect.net

Organizations & group practices 5

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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1609084730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17560 US HIGHWAY 441",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327576711",
            "telephone_number": "352-744-7002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17560 US HIGHWAY 441",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327576711",
            "telephone_number": "352-744-7002",
            "fax_number": "352-735-3233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7101 Fairway Dr",
            "address_purpose": "LOCATION",
            "city": "Palm Beach Gardens",
            "state": "FL",
            "postal_code": "334183701",
            "country_code": "US",
            "telephone_number": "561-515-1500",
            "fax_number": "561-515-1588",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5743 Williamsburg Ln",
            "address_purpose": "LOCATION",
            "city": "Wildwood",
            "state": "FL",
            "postal_code": "347858129",
            "country_code": "US",
            "telephone_number": "352-744-7002",
            "fax_number": "352-735-3233",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 N 14th St",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "FL",
            "postal_code": "347484204",
            "country_code": "US",
            "telephone_number": "352-787-5900",
            "fax_number": "352-735-3233",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17556 SE 109th Terrace Rd",
            "address_purpose": "LOCATION",
            "city": "Summerfield",
            "state": "FL",
            "postal_code": "344916907",
            "country_code": "US",
            "telephone_number": "352-347-2100",
            "fax_number": "352-735-3233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACION",
        "first_name": "MARICELY",
        "middle_name": "GONZALEZ",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Dora, FL

Sources for this page

Verify at the official NPI Registry.