Mark Steven Rakoczy, O.D.
Individual provider Active NPI Optometrist · Everett, PA
NPI 1720076433 · NPPES record last updated Nov 30, 2017
Key facts
- NPI
- 1720076433
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- OEG000168 (PA)
- Practice address
- 141 E Main St
Everett, PA 15537-1259 - Phone
- (814) 652-6221
- Fax
- (814) 652-9143
- NPI assigned
- Oct 7, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Everett Eye Care Center, LLC | Optometrist | Past |
Accepting new patients |
Interoperability endpoints
- direct@everetteyecarecentereverettpa.compulinkdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OEG000168 | PA | Yes |
Addresses
Primary practice location
141 E Main St
Everett, PA 15537-1259
Mailing address
141 E Main St
Everett, PA 15537-1259
Phone (814) 652-6221
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0010341570002 | Medicaid | PA | |
| 204217 | Other | PA | UPMC |
Other providers in Everett, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.