NPIMap

Organization Active NPI

Marin Eye Care

  • Optometrist
  • Novato, CA
National Provider Identifier
1679087290
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9545T Issued in CA
Legal business name
MARIN EYE CARE
Practice address
440 Ignacio Blvd
Novato, CA 94949-6085
Phone
(415) 883-9888
Fax
(415) 883-1159
NPI assigned
Nov 17, 2017
Last updated
Nov 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Authorized official

Name
Susan Mozayani, ODNPI 1417967225
Title
Owner
Phone
(415) 883-9888

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13793T CA
Optometrist 152W00000X 15419 CA
Optometrist 152W00000X 9545T CA Primary

Addresses

Primary practice location

440 Ignacio Blvd
Novato, CA 94949-6085

Mailing address

440 Ignacio Blvd
Novato, CA 94949-6085
Phone (415) 883-9888

Other identifiers 1

IdentifierTypeStateIssuer
1417967225OtherCABLUE SHIELD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1510876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699488000000",
    "number": "1679087290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 IGNACIO BLVD",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949496085",
            "telephone_number": "415-883-9888",
            "fax_number": "415-883-1159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 IGNACIO BLVD",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949496085",
            "telephone_number": "415-883-9888",
            "fax_number": "415-883-1159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIN EYE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-17",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A",
        "authorized_official_last_name": "MOZAYANI",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "415-883-9888",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13793T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "15419",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9545T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "1417967225",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Novato, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; 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.