Individual provider Active NPI

Mark Davis Robertson, O.D.

  • Optometrist
  • Saipan, MP
National Provider Identifier
1720142466
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0015 Issued in MP
Practice address
503900 Mooty 13 Fishermen Beachroad, Garapan
Saipan, MP 96950-3900
Phone
(670) 235-9090
Fax
(670) 235-9091
NPI assigned
Dec 20, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0015 MP Primary

Addresses

Primary practice location

503900 Mooty 13 Fishermen Beachroad, Garapan
Saipan, MP 96950-3900

Mailing address

PO Box 503900
Saipan, MP 96950-3900
Phone (670) 235-9090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MP
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
I20120312000427 MP Practitioner - Optometry 8022277045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Marianas Eye Institute Inc Optometrist CurrentSince Jan 11, 2002 Accepting new patients

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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1720142466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 503900",
            "city": "SAIPAN",
            "state": "MP",
            "postal_code": "969503900",
            "telephone_number": "670-235-9090",
            "fax_number": "670-235-9091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503900 MOOTY 13 FISHERMEN BEACHROAD, GARAPAN",
            "city": "SAIPAN",
            "state": "MP",
            "postal_code": "969503900",
            "telephone_number": "670-235-9090",
            "fax_number": "670-235-9091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "MARK",
        "middle_name": "DAVIS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MP",
            "license": "0015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saipan, MP

Sources for this page

Verify at the official NPI Registry.