Individual provider Active NPI

Don E Marascalco, M.D.

  • Ophthalmology Physician
  • Meridian, MS
National Provider Identifier
1649294935
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MS009634 Issued in MS
Practice address
1301 20TH Ave
Meridian, MS 39301-4121
Phone
(601) 485-2368
Fax
(601) 693-2174
NPI assigned
Jul 27, 2006
Last updated
May 19, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2008

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 MS009634 MS Primary

Addresses

Primary practice location

1301 20TH Ave
Meridian, MS 39301-4121

Mailing address

PO Box 1551
Meridian, MS 39302-1551
Phone (601) 485-2368

Other identifiers 6

IdentifierTypeStateIssuer
00116642MedicaidMS
051550436MedicaidAL
180041626OtherMSRAILROAD MEDICARE
CH6608OtherALRAILROAD GROUP ID
CH5554OtherMSRAILROAD MEDICARE GROUP
180041976OtherALRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, 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
I20100830000609 MS Practitioner - Ophthalmology 9335045905 Reassigns benefits to 1 organization
I20110113000303 AL Practitioner - Ophthalmology 9335045905 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MS009634MSMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Clinic of Meridian PLLC Ophthalmology CurrentSince Dec 29, 2000 Accepting new patients
Butler Optical Center,Inc Past Accepting new patients
Custom Optical, Inc. PastSince Jan 4, 1999 Accepting new patients

Locations

130 N Mulberry Ave
Butler, AL 36904
Phone (205) 459-2460

504 E Pushmataha St
Butler, AL 36904
Phone (205) 459-2460

1301 20th Ave
Meridian, MS 39301
Phone (601) 485-2368

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, 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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211155200000",
    "number": "1649294935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1551",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393021551",
            "telephone_number": "601-485-2368",
            "fax_number": "601-693-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 20TH AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014121",
            "telephone_number": "601-485-2368",
            "fax_number": "601-693-2174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARASCALCO",
        "first_name": "DON",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2008-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MS",
            "license": "MS009634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00116642",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051550436",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180041626",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD GROUP ID",
            "identifier": "CH6608",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "CH5554",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180041976",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.