Organization Active NPI

Michael E. Marden, O.D.

  • Optometrist
  • Rockport, ME
National Provider Identifier
1649452293
Registry record updated Dec 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT591 Issued in ME
Legal business name
MICHAEL E. MARDEN, O.D.
Practice address
377 Commercial St
Rockport, ME 04856-4403
Phone
(207) 236-8879
Fax
(207) 236-3885
NPI assigned
Dec 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2007

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

Authorized official

Name
Michael E. Marden, O.D.NPI 1265532139
Title
Owner
Phone
(207) 236-8879

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X OPT591 ME Primary

Addresses

Primary practice location

377 Commercial St
Rockport, ME 04856-4403

Mailing address

377 Commercial St
Rockport, ME 04856-4403
Phone (207) 236-8879

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040929000074 ME Part B Supplier - Clinic/Group Practice 1557330362 Receives reassigned benefits from 2 practitioners
Practice locations: Belfast, ME

National Provider Directory

National Provider Directory

Locations

11 Swan Lake Ave
Belfast, ME 04915
Phone (207) 338-1900

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196812800000",
    "number": "1649452293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "377 COMMERCIAL ST",
            "city": "ROCKPORT",
            "state": "ME",
            "postal_code": "048564403",
            "telephone_number": "207-236-8879",
            "fax_number": "207-236-3885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 COMMERCIAL ST",
            "city": "ROCKPORT",
            "state": "ME",
            "postal_code": "048564403",
            "telephone_number": "207-236-8879",
            "fax_number": "207-236-3885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL E. MARDEN, O.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-05",
        "last_updated": "2007-12-05",
        "status": "A",
        "authorized_official_last_name": "MARDEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-236-8879",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "ME",
            "license": "OPT591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockport, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.