Mark Lee Guisti, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

0700004503 Issued in NV

Practice address

2363 N 5TH St
Ste 106
Elko, NV 89801-4593

Phone

(775) 738-3508

Fax

(775) 738-4618

NPI assigned

Jun 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281484800000",
    "number": "1679518757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2363 N 5TH ST",
            "address_2": "STE 106",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898014593",
            "telephone_number": "775-738-3508",
            "fax_number": "775-738-4618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2363 N 5TH ST",
            "address_2": "STE 106",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898014593",
            "telephone_number": "775-738-3508",
            "fax_number": "775-738-4618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUISTI",
        "first_name": "MARK",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2010-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "0700004503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002504510",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410026356",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA MEDICARE DMERC REGI",
            "identifier": "0805550001",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Elko, NV
• Providers in Elko, NV by specialty
• Optometrist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2010; 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.