Individual provider Active NPI

Marjorie Fricke Debenedictis, MD

  • Ophthalmology Physician
  • Tamuning, GU
National Provider Identifier
1659458248
Registry record updated Jun 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
M001334 Issued in GU
Practice address
633 Gov Carlos Camacho Rd.
Suite 103
Tamuning, GU 96913-3300
Phone
(671) 647-5829
Fax
(671) 647-5830
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
Yes

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.

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Southern California Keck School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

633 Gov Carlos Camacho Rd
Suite 204
Tamuning, GU 96913
Phone (671) 647-5829

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
93.3 of 100Reported as individual
Quality
99.47
Improvement activities
40
Cost
78.39

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20060508000632 HI Practitioner - Ophthalmology 7618983149 Reassigns benefits to 1 organization
Receives reassigned benefits from 1 practitioner
Practice locations: Tamuning, GU

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M001334GUMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marianas Eye Institute Inc Ophthalmology CurrentSince Oct 1, 2019 Accepting new patients
Island Eye Center Ophthalmology PastSince Jul 23, 2007 Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X M001334 GU Primary

Addresses

NPPES NPI Registry

Primary practice location

633 Gov Carlos Camacho Rd.
Suite 103
Tamuning, GU 96913-3300

Mailing address

633 Gov Carlos Camacho Rd.
Suite 103
Tamuning, GU 96913-3300
Phone (671) 647-5829

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 12, 2013.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1659458248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 GOV CARLOS CAMACHO RD.",
            "address_2": "SUITE 103",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133300",
            "telephone_number": "671-647-5829",
            "fax_number": "671-647-5830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 GOV CARLOS CAMACHO RD.",
            "address_2": "SUITE 103",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133300",
            "telephone_number": "671-647-5829",
            "fax_number": "671-647-5830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBENEDICTIS",
        "first_name": "MARJORIE",
        "middle_name": "FRICKE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GU",
            "license": "M001334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamuning, GU

Sources for this page

Verify at the official NPI Registry.