Individual provider Active NPI

Mark Feldner, DO

  • Optometrist
  • Vero Beach, FL
National Provider Identifier
1659021293
Registry record updated Mar 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
DO0004253 Issued in FL
Practice address
530 21St St
Vero Beach, FL 32960-5450
Phone
(772) 562-2020
Fax
(772) 562-5874
NPI assigned
Mar 26, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X DO0004253 FL Primary

Addresses

Primary practice location

530 21St St
Vero Beach, FL 32960-5450

Mailing address

530 21St St
Vero Beach, FL 32960-5450
Phone (772) 562-2020

Other identifiers 1

IdentifierTypeStateIssuer
DO0004253OtherFLABO LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL STOREVERO@POWEROG.COM Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO0004253FLMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1648252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648252800000",
    "number": "1659021293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 21ST ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329605450",
            "telephone_number": "772-562-2020",
            "fax_number": "772-562-5874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 21ST ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329605450",
            "telephone_number": "772-562-2020",
            "fax_number": "772-562-5874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELDNER",
        "first_name": "MARK",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-26",
        "last_updated": "2022-03-26",
        "certification_date": "2022-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "DO0004253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ABO LICENSE",
            "identifier": "DO0004253",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "STOREVERO@POWEROG.COM",
            "affiliation": "N",
            "endpointDescription": "BUISNESS EMAIL",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "DIRECT MESSAGE",
            "address_1": "530 21st St",
            "city": "Vero Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "329605450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.