Individual provider Active NPI

Mark Coan, OD

  • Optometrist
  • Ocoee, FL
National Provider Identifier
1689698599
Registry record updated Mar 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 2988 Issued in FL
Practice address
10101 W Colonial Dr
Suite 100
Ocoee, FL 34761-4213
Phone
(407) 445-5170
Fax
(407) 299-5036
NPI assigned
Jul 26, 2006
Last updated
Mar 7, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC 2988 FL Primary

Addresses

Primary practice location

10101 W Colonial Dr
Suite 100
Ocoee, FL 34761-4213

Mailing address

10101 W Colonial Dr
Suite 100
Ocoee, FL 34761-6800
Phone (407) 445-5170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121004000084 FL Practitioner - Optometry 4082892260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roxanne Achong OD, PAGroup PAC ID 2668572280, 2 clinicians

Practice addresses (Care Compare)

10101 W Colonial Dr
Ocoee, FL 34761-4213
Phone (407) 445-5170

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 2988FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Roxanne Achong OD, PA Optometrist CurrentSince Nov 15, 2001 Accepting new patients

Locations

10101 W Colonial Dr
Ste 100
Ocoee, FL 34761
Phone (407) 445-5170

10101 W Colonial Dr
Ocoee, FL 34761
Phone (407) 445-5170

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204848000000",
    "number": "1689698599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10101 W COLONIAL DR",
            "address_2": "SUITE 100",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347616800",
            "telephone_number": "407-445-5170",
            "fax_number": "407-299-5036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 W COLONIAL DR",
            "address_2": "SUITE 100",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614213",
            "telephone_number": "407-445-5170",
            "fax_number": "407-299-5036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COAN",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2008-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 2988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocoee, FL

Sources for this page

Verify at the official NPI Registry.