Individual provider Active NPI

Marc H Sherman, OD, PA

  • Vision Therapy Optometrist
  • Longwood, FL
National Provider Identifier
1629060751
Registry record updated Jun 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vision Therapy OptometristTaxonomy code 152WV0400X
License
OPC1051 Issued in FL
Practice address
1495 W State Road 434
Suite 109
Longwood, FL 32750-3847
Phone
(407) 332-8255
Fax
(407) 332-5769
NPI assigned
Aug 16, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC1051 FL
Vision Therapy Optometrist 152WV0400X OPC1051 FL Primary

Addresses

Primary practice location

1495 W State Road 434
Suite 109
Longwood, FL 32750-3847

Mailing address

1495 W State Road 434
Suite 109
Longwood, FL 32750-3847
Phone (407) 332-8255

Other identifiers 2

IdentifierTypeStateIssuer
084456000MedicaidFL
D04539OtherFLRAILROAD MEDICARE

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
I20090213000368 FL Practitioner - Optometry 1254496821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1495 W S R
Suite 109
Longwood, FL 32750-3861

1495 W St Rd
434 Suite 109
Longwood, FL 32750-3861
Phone (407) 332-8255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Marc H Sherman OD PA Optometrist CurrentSince May 1, 2008 Accepting new patients
Steven J Zorn OD PA Optometrist Past Accepting new patients

Locations

1495 W State Road 434
Ste 109
Longwood, FL 32750
Phone (407) 332-8255

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1629060751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1495 W STATE ROAD 434",
            "address_2": "SUITE 109",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327503847",
            "telephone_number": "407-332-8255",
            "fax_number": "407-332-5769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1495 W STATE ROAD 434",
            "address_2": "SUITE 109",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327503847",
            "telephone_number": "407-332-8255",
            "fax_number": "407-332-5769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERMAN",
        "first_name": "MARC",
        "middle_name": "H",
        "credential": "OD, PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC1051",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "FL",
            "license": "OPC1051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084456000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "D04539",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longwood, FL

Sources for this page

Verify at the official NPI Registry.